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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified MD
Category: Neurology
Satisfied Customers: 63757
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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my daughter 7 yrs old contacted mengitus at 7 weeks old resulting

Customer Question

my daughter 7 yrs old contacted mengitus at 7 weeks old resulting in hydrocaphalus, her mri scan from 2 years ago stated the following damage: frontal horn and body of right lateral ventrical are decompressed, right temporal horn conciderably more dilated, and its exerting mass effect on on midline structures also on body of right lateral ventrical, left lateral ventrical is more decompressed although retains a bizarre contour. there is an area of adjacent porencephaly. The cavum vergae remains prominent and septated, 4th ventrical also remains prominent with elevation of tectal plate. There is established porencephaly on the left with overall loss of white matter in the left cerebral hemisphere compared to right. Basal ganglia are distorted but 'i cannot see a definate signal abnormality within.
I was wondering if this could be explained in plain english to me please.
My daughter has a severe global development delay and a shunt. I have been told the scan results are in contrast to her actual development: she walks and gross motor function is ok, she has great level of understanding however her verbal skills are very limited, she can hum nursery rhymes and can recall any one she learned so memory is good. can say yes no and about 10 other words. she sees and hears fine,
I am wondering if there is anything in above that would indicate something else that could be done to assist her development like removal of some of the cycst of fluid etc, her teachers (in special school) feel her sensory issues are holding her back, any advise on things I could or should be asking?
Submitted: 3 years ago.
Category: Neurology
Expert:  Shantal-Mod replied 3 years ago.

Hello,

I've been working hard to find a Professional to assist you with your question, but sometimes finding the right Professional can take a little longer than expected.

I wonder whether you're ok with continuing to wait for an answer. If you are, please let me know and I will continue my search. If not, feel free to let me know and I will cancel this question for you.

Thank you,

Shantal

Expert:  Dr. Thomas, MD replied 3 years ago.
Hello from JA
Basically what this means is that parts of the ventricles and other structures have been damaged and compressed from the hydrocehphalus, a lot of this probably occurred before she had the shunt.

What exactly have the doctors told you
Customer: replied 3 years ago.

Hi I thank you for taking the time respond, The neurologist that was over her case since the beginning told me that the mengitius that caused the hydro caused a number of pockets of fluid, the shunt would only reach the 1 or 2 main ones and that there are a number of pockets that will never be reached by the shunt and time will tell what will happen to the others, he also told me that her brain is continuing to grow and develop which is encouraging, unfortunately due to cuts etc he has retired and no one else has fully replaced him and im concerned that no one is keeping an eye on it, I requested her records and have been going through them as best I can, my daughter was never seen by a neurosurgeon and im trying to get one, I suppose my main question is these pockets of fluid or cysts, can her brain continuing to grow put pressure on these? can they be removed or do they just stay there? if they could be removed is there a chance they could improve elements of her development and am I right to keep trying to get a neurosurgeon to review her or just wait for a new neurologist? not to sure on difference. Its just hard when you loose a great support network that new and understood the case, he always said it was a very unusual case one in his 23 yrs he had never really seen, I think he was referring to the level of protein (14.4g) and infection, but also the scans and all the divisions of fluid. He did request a 2nd opinion from the top peads neurosurgeon however before he could see her she needed an emergency op and it never happened, im just trying to see what he might have done next? sorry for all the questions im just not sure how much or little info you need, I know they cant all be answered its mainly guidence on what or where to go or do next and for you to maybe say what is or is not important for me to focus on.

Expert:  Dr. Thomas, MD replied 3 years ago.
How long ago was this scan?
Customer: replied 3 years ago.

It was 2 years ago, I have asked for another but was told she would be in pain if anything wrong but im not so sure as it never happened like that the last time? p.s i dont mind waiting for answer if you are busy and also understand and appreciate the time you take to answer i will pay extra for that time (might not be a fortune but what ever i can afford!!)

Expert:  Dr. Thomas, MD replied 3 years ago.
OK
There is absolutely no contradindication to getting a repeat MRI
You want to know if nay of this has improved, with the shunt it might have.
That would explain improved function, and give you some answer to your questions.

I don't see an Obvious surgical intervention here unless there is still pressure that can be relieved.

You don't even really know with a 2 year old scan.

Your next steps
Neurologist and neurosurgeon and repeat scan.

There are going to be long term deficits, but this child should be getting physical therapy and occupational therapy, etc.

As to more surgery, it is likely not indicated as I said...BUT can not say completely without the new scan and neurosurg assessment of her, the child.

OK. If you have further questions or details, use reply to expert.
Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

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