I hate that my first post on the message boards is going to be a bit of a rant but I am so mad this evening I just have to get it off my chest to those who understand.
I picked up my MRI reports on the way to the neurologist today so I could read them myself. Now bear in mind my PCP has already set me up to see a neurosurgeon but he wanted me to still keep the appointment he had made me with the neurologist because it takes so long to get in to see one around here and he wanted to make sure there wasn't something else going on he might have missed. Anyway, I have had two MRIs. The first was of my brain on 6/29 and the second was of my spine that was done on Monday. Part of Monday's MRI was ready, but part has not been signed by the radiologist so they could not release it to me yet as it was still marked preliminary and not final. They read:
Brain:
A Chiari I abnormality is present at the craniocervical junction, the cerebellar tonsils passing inferiorly to the level of the posterior arch of C1. The posterior CSF space is likely effaced. Additionaly, a large syrinx is present within the visualized cervical spinal cord, which extends inferiorly from the C1 level beyond the imaging field of view. Syrinx diameter measures approximately 11 x 9mm. Further imaging of the dorsal and lumbar spine would be appropritate to determine if this is a benign syrinx associated with a Chiari I anomaly or if a neoplastic process is associated. Additionally, neurosurgical referral should also be considered for additional consultation. Conclusion: Chiari 1 anomaly in association with a partially visualized large central syrinx in the visualized cervical cord which extends from approximately the C1 vertebral level inferiorly. Further imaging of the dorsal and lumba spine needs to be considered to evaluate the extent of the syrinx and determine if there is any associated neoplasam. Additionally, in this context, neurosurgical consultation would not be inappropriate to assist patient assessment and management.
Thoracic:
The cerebellar tonsils have a pointed configuration and project below the level of the foramen magnum. Ther is abnormal expansion of the central canal/cervical cord extending from the cervicomedullary junction to the level of C5. There is a prominent flow artifact within this cavity which is most consistant with syrinx. Post contrast images demonstrate no appreciable enhancement. There a no acute vertebral findings. Nornal spine alignment. Small disc osteophyte complexes are noted posteriorly in the cervical spine. No significant degenerative changes. Conclusion: Arnold Chiari 1 malformation with associated cervical spine syrinx.
I hope to recieve the lumbar mri results later this week.
Anyway the neurologist that I saw today was horrid. I understand that a neurologist is not who you need to see for chiair but I had no idea as to how uninformed and dismissive this man would be. All he could focus on was my headaches. I repeatedly brought up my other neurologic symptoms and the fact that I have went from being able to do anything a grown man can do on my farm to barely being able to function. He did no testing what so ever on my balance even after I told him that I can't close my eyes to wash my hair in the shower without falling over. He dismissed the paresthesia and weakness apparently because I can feel cold, vibration, and "sticks" from a toothpick. He just kept focusing on the headache over and over again and told me that chiari is only ever an incidental finding and that it or the syrinx would not cause any numbness,loss of words, loss of memory, balance problems, severe leg pain, or any other symptoms and that it only needs treated if I pass out when I cough. I kid you not. His solution was to order an vascular CT (I'm sure it has another name but I was so furious at this point it didn't stay with me) and prescribe beta blockers, an antidepressant, muscle relaxers, and a migraine rescue med. He told me I simply have a tension headache and he is interested to hear with the neurosurgeon says because again, chiari is only treated if I were to pass out when I coughed. I wanted to make him pass out with a punch in the head. *lol*
I just keep thinking that I can't imagine where I would be if my PCP hadn't ordered the MRI. This guy certainly wouldn't have referred me to a neurosurgeon. Ack! Sorry for the vent but I am just so frustrated right now.