Symptomatic Choroidal Fissure Cyst with Hippocampal Formation Mass Effect: which specific sub-structures is it distorting?
Hi all! Right-sided arachnoid choroidal fissure cyst here (first diagnosed via MRI in 2015). The video/images included are all from the latest MRI in 2020.
TL;DR: my cyst has fluctuated in size/distribution, and MRI reports since 2018 mention mass effect to the hippocampal region. I'm hoping someone can help me identify in more detail which specific anatomical (sub)structures are affected because the latest report I have is vague in that aspect. About in 2018 I saw a nationally-recognized neurologist in my home country who explained that the cyst was likely causing (or exacerbating) some of my psychiatric symptoms due to the specific placement. Where I live (Australia) the imaging reports are a lot more vague so I can't tell if the mass effect they refer to now is the same or not as the one my neurology team identified back home in 2018. If there are changes in which sub-structures are affected it'd help justify the substantial expense of seeing a specialist neurologist here given that the cyst itself doesn't require actual intervention.
I have access to the entire set of images in case that helps with more detailed identification.
Detailed background/case presentation:
I've been monitoring my cyst since it was first diagnosed in 2015, which has fluctuated in size over time. For reference, all MRIs were done at the exact same imaging clinic where I live (Australia) except for the one in 2018 that was done in my home country (Argentina). In Australia my MRI reports have gone directly to my general practitioner (GP), unlike in Argentina where I discussed them at length with a neurology team.
At first in 2015 the largest measurement was 18mm and there was no reported lesion/mass effect. A follow-up MRI in 2016 showed no changes.
In early 2018 an MRI showed it had grown to 24mm and lesions/mass effect were first mentioned. The report I received in 2018 was more detailed because it was written by the neurologist I was seeing in my home country when I went to visit. I was given a lot more detail about the affected sub-structures, including the fornix which appears to be symptomatic due to issues I have with spatial navigation. They also suggested strong links with increased anxiety and increased impairments from my Autism and ADHD.
A follow-up MRI in Australia in late 2018 confirmed an increase in size from 2015. There was only a 1mm difference between the 2018 MRIs in Argentina (24mm) vs Australia (23mm) so that ruled out a technical discrepancy.
The last MRI from 2020 showed the cyst had reduced in size (down to 19mm) closer to its original size in 2015. But the report still mentions 'mass effect with distortion to the hippocampal formation'.
I was hoping someone could give me more insight on the specific sub-structures/regions that show mass effect.
Thank you in advance!!