I had the brain CT with iodixanol (contrast agent) today.
The report is as follows:
[MR BRAIN PRE & POST CONTRAST
Technique : Standard brain with diffusion and pre and post contrast and slight imaging of the pituitary gland.
Findings :
Brain anatomy is normal.
No pituitary mass is seen.
Linear T1 hypo / T2 hyperintense focus anterior to the neurohypophysis of uncertain significance. This does not have the appearance of a neoplasm or the shape of a cyst.
Brain parenchymal signal is normal.
There is no intracranial mass, hydrocephalus or midline shift. No abnormal parenchymal or meningeal enhancement is seen.
The craniocervical junction is normal. The intracranial vascular flow voids are normal.
There is a mucosal cyst anterior to the adenoid within the nasopharynx most likely representing a mucous retention cyst.
COMMENT
No pituitary mass or brain abnormality is seen.]
So there we have all. Diagnostic done. I have done EVERYTHING I possibly can.
Hi Dominique-
ReplyDeleteI am the surgeon that wrote the report of two cases of "arthroprosthetic cobaltism" that was published December 2010. My clinic now has 5 likely cases of neurologic poisoning and 4 cases of likely cardiac poisoning due to high blood cobalt levels. Two patients had ASR hips and three had Birmingham hip resurfacings. Three of the patients (including myself) went through the depression/ cognitive decline that you are experiencing. The good news is we all improved as our cobalt levels declined. The patient most recently revised had neuro-cognitive testing before revision and we found general decline in almost all areas but very marked decline in some specific memory and learning processes. This fits with what is known about long term cobalt exposure in industry.
What were your cobalt levels?
You might considered formal neuro-cognitive testing now and then every three months after your ASR is revised. There is a quick abbreviated test battery used to follow athletes after head injury, the IMPACT. It is quick, computer administrated, inexpensive, and in our experience helpful in documenting the "cognitive decline" of cobaltism and the recovery after revision surgery.
You might also consider a cardiac echocardiogram and an audiogram. Both are likely to be abnormal now and are likely to improve over the first two years after your revision surgery.
Our three most severely poisoned cases had headaches similar to yours, loss of high frequency hearing, non-specific visual changes. Four of our cases also had "stiffening" on the heart (reversible), several had new or worsened high blood pressure and increased resting heart rate.
Take heart, all of our cases have improved after revision surgery on all fronts.
Sincerely,
Dr. Cobaltism AKA
Stephen S. Tower, M.D.
sstowertop@gmail.com