Incidental finding or potentially relevant?
TLDR: is this anything?
Just discussed radiology report with my neurologist, report did not mention this area on imaging (dark crescent left lateral frontal/temporal region, ~7.8mm at widest part). The report also didn’t mention a large paranasal retention cyst (~2.5cm) which I know is an incidental finding, but it made me concerned that findings may be omitted that could be relevant.
Current issue: new daily headache following procedure involving spinal anesthetic. Started as classic PDPH (positional headache, light/sound sensitivity, tinnitus, etc), attempted conservative management for 2 months (fluids,caffeine, bed rest). Headache changed somewhat in that time - along with “classic” symptoms, now experiencing some days waking up with headache (as opposed to developing through the day when upright) and headache no longer fully relieved by lying flat. Anesthesia did not want to perform blood patch due to change in symptoms, referred to neurology & imaging.
Radiology report - MRI/MRV brain & MRI spine showed no evidence of CSF leak, no pathological enhancement or evidence of prior hemorrhage. My neurologist did not review DICOM directly at appointment (or at all?). I know the spot in image is likely CSF - not enhancing on FLAIR, bright on T2, but there is a dark spot (?) on DWI. Obviously not a radiologist though!
History of migraines with aura (lifelong) and head trauma in childhood/adolescence - 2 incidents involving loss of consciousness, did not go to hospital.
Demographics: 30F, 190lb, 5’8”. Non-smoker. Meds - propranolol, rizatriptan, Cambia
Not asking for diagnosis or anything, would just like to know if this worth a second opinion? Or am I just really overthinking a benign finding?