Posted by: Johan | 2010-01-10

Off balance feeling

Dear Doctor

After many consultation, hospitalizations and test I still have no answers. I have an off balance and foggy feeling in my head with a lame feeling to the left side of my body. I was admitted by a hart specialist but he said everything is fine nothing wrong with my hart. My cholesterol is 3, sugar is also fine.

Went to a neurosurgeon whom sends me for MRI and CT scan. The report read as follow:
1. 11,5mm x9mm cystic structure anterior to the right lateral middle cerebral artery cistern, at the point where the distal M1 portion of the right middle cerebral artery trifurcates.
2. It is impressing into the adjacent brain parenchyma of the right inferiorposterior frontal lobe.
3. The cystic lesion is bean-shaped and follows CSF signal on all sequences, without rim enhancement.
4. The left vertebral artery is markedly hypoplastic and at the basilar tip, the left posterior cerebral artery is absent.

Arachnoid cyst communicating with the anterior aspect of the distal right middle cerebral artery cistern
No T2WI FLAIR foci representing areas of chronic ischaemia/infarction
No leukoaraiosis
Vertebrobasila insufficiency syndrome, with hypoplastic left vertebral artery and absent left PCA.

CT scan
1. Deviation of the central bony nasal septum towards the left side, with bony spur projecting between the inferior left turbinate.
2. Mild, dependant nodular micosal thickening in both maxillary antra, more marked on the right side.
3. These are small mucous retention cysts.
4. Mucosal swelling over the turbinates.

1. Small dependant mucous retention cyst in both maxillary antra.
2. Deviation of the bony septum.
3. Right concha bullosa.

The neurosurgeon said there is nothing wrong with me and I just have to live with this feeling. I’ m at the stage that I’ m getting depressed as doctor the see me give me one look and blame it on my weight. Also when to 3 different ENT specialist with no luck as I thought it can be my ears as I’ m partially deaf. Do you think when reading the MRI and CT scan I accent this feeling or need to see other doctor.

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Our expert says:
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I am not sure what the significance of the inter-cranial cyst is. Therefore, I do suggest that you get a second opinion from a neurologist or neurosurgeon. Deviation of the nasal septum can cause sinusitis and following balance problems. Once again, I am not sure of the significance of the right concha bollosa and do not know if this will cause your symptoms and hence, it will be a good idea to get a fourth opinion from an ENT specialist about this cyst and the relation to your symptoms.

Good luck and please let me know about the outcome.


Dr Anrich Burger

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