Undiagnosed brain lesion.

Forgot to add. My husband is a 51 years old disabled veteran. History of diabetes, hypertension, CAD, lower extremities injuries, and recent silent heart attack. He has complained for years about dizziness, muscle atrophy, weakness, frequent fluctuations in blood sugar levels and blood pressure. The stroke like episodes don’t last long but during them he has noticeable droop on one side face, confusion, slurred speech, says he knows what he wants to say but can’t get it out, and typically his BP is low during this time.

@hnrharrison From what you have shared it is evident that your husband has multiple health problems that must make it difficult for the two of you. We aren't medical professionals here at Mayo Clinic Connect so we cannot answer your question. Your husband's symptoms including the stroke-like episodes are certainly worrisome and could indicate a lesion but only a medical specialist can answer that question.

Have you discussed this with your husband's primary care provider? Or a neurologist?

His primary care told us his original MRIs only showed mild sinusitis. No mention of the lesion at all. We have been begging for a neuro referral since March when his new symptoms started and we discovered the previous abnormal tests. It’s taking this long just to get the additional tests done and he hasn’t been seen by his primary care or neuro during any of this. I understand medical advice can’t be given I’m just wondering if anyone that’s been diagnosed with a stroke or occlusion had previous MRIs that simply showed that as a lesion. Since we don’t know if we are dealing with two different brain issues or is it all the same thing.

You should obtain copies of the test results and the tests themselves on CD and contact an attorney if the radiology reports failed to note the lesions were present. I wouldn’t trust the word of the neurologist until I saw the report especially if it’s the same one you’ve been going to.

@hnrharrison I'm not a medical professional however from everything you have shared I understand why you want to know if your husband's symptoms are associated with the findings on the scanning results. With these most recent findings that you shared on the CTA and MRA that were done last month detailing the probable occlusion with the left hemisphere MCA (middle cerebral artery) and changes within the territory around the ACA (anterior communicating artery) would result in me asking the same questions as you. Can occlusions look like lesions in brain scans? I'm thinking that since a CTA and MRA were ordered that the physician who ordered these wanted to find. out more about your husband's arteries and blood vessels in the brain.

A narrowing, or occlusion (stoppage) of the blood vessels in the brain can result in what we often think of as strokes. When the brain tissue is affected by those changes in the brain blood vessels then that brain tissue is what is referred to as a lesion that shows up on brain scans.

Computed Tomography Angiography (CTA) from Johns Hopkins University:

-- https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/computed-tomography-angiography-cta

Magnetic Resonance Angiography (MRA) from Cleveland Clinic:

-- https://my.clevelandclinic.org/health/diagnostics/24024-mra

I don't have personal experience with this. If this were occurring with my husband I'd be advocating for him just as you are doing.

If you and your husband are interested in a second opinion/consult with Mayo Clinic then here is the information you will need to request an appointment. Your husband can refer himself or better yet your husband's physician can make the referral with the supporting scans and medical documentation.
http://mayocl.in/1mtmR63

My husband is being treated by the VA. The first 2 MRIs showing the 8mm lesion on the right were never even disclosed to us. He was told in 2022 that the MRI simply showed mild sinusitis, and in 5/23 he was told the 2023 MRI simply showed no acute abnormality or reasoning of muscle atrophy. The recent MRA (that indicates something on the left) was done because a neuro e-consult recommended it based on a 4/2023 head CT that showed possible old infarction after he started having stroke like symptoms. And the radiologist who read the MRA recommended the CTA. His primary care has not seen him since 1/23 even though we have made multiple requests to be seen, they have had no urgency in these tests (note stroke symptoms started in March and the MRA was just done in June) and he has yet to be seen by a neurologist at all! I am trying to get anyone to help explain what is going on with him and what treatment is needed. And also if the abnormal tests done in 2022 and 2023 were acknowledged and looked into could his current condition have been prevented.

Does anyone know if Mayo will charge for a consultation or records review? Because he doesn’t have insurance other than the VA. And they haven’t sent him to one of their own neurologists so I know they won’t cover Mayo.

@hnrharrison I am tagging @eddiereen who started a discussion on getting VA approval for a Mayo Clinic consult:

-- https://connect.mayoclinic.org/discussion/getting-va-approval-for-mayo-is-a-nightmare/

Is your husband 65 years old or over and so qualifies by age for Medicare? If so, that will be useful in getting him to Mayo Clinic as he will have an option for insurance coverage with Medicare.

I am also tagging a few others who have suggestions and comments on working with the VA to get an outside consult. @19lin One of the Volunteer Mentors @johnbishop is a veteran and although he has not used the VA system he has had suggestions for helping a person through this process. Here is a website that @johnbishop recommended to get started:

About VA Health Benefits:

-- https://www.va.gov/healthbenefits/

Please read through some of these and then come back and ask other questions. Hopefully, others with VA experience will jump in here and provide you with suggestions.

Unfortunately he is not 65. He is 51 and 60% VA rated. He’s been unable to work due to his disabilities for over a year and a half so he is completely dependent on the VA for healthcare. I have been all through the VHA policies about consults and referrals but he is at their mercy on this. Which has been the problem since this started or I would have at least had him seen by a local neurologist. We have multiple complaints against his primary care providers about the neglect he’s received but still not getting any real results.