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Lesion in CEREBELLUM without enhancement in MRI. NEOPLASTIC?

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JI've had migraines but maybe only 1-4 a year. I was having some numbness and tingling a couple of years old patientago with my migraines. My primary sent me to a neurologist. He ordered a mri. An 8mm lesion was found on my left cerebellum. An mri with contrast was done and nothing enhanced. my neurologist said highly unlikely it is a tumor. Did not contrast nor did it look anything characteristic of a tumor. I have not had any symptoms in 5 years. No numbness or tingling. What are the other possible options? Could it be a harmless lesion ...is that even possible? Could it be a tumor even though I haven't had any symptoms in 5 years?Radiology report reads...9mm white matter lesion shows no contrast enhancement. No mass effect of edema. No other lesions seen. Could represent dymelination process such as multiple sclerosis, inflammation, infection or least likely nonenhancing neoplastic process.
Other than the occasional migraine in the last 5 years old patientI have had no symptoms. I had no seizures no consistent headaches or pressure. Could this be a tumor? Or is it unlikely without symptoms after 5 years? What else could it be?

Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Thank you for posting your query at DoctorSpring.com
I have noted your symptoms and MRI brain findings.
I agree that it is unlikely to be a tumor.
These white matter lesions are most commonly seen in migraine. Other common causes are ischemia (lack of blood flow to brain) or demyelination (such as multiple sclerosis). MS is unlikely with a single lesion.
In conclusion, there is no need to worry about that lesion on MRI brain, as it can not be anything serious. Repeat MRI brain may be done, if there are new symptoms such as worsening headache, numbness or weakness of arm or leg.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

Patient replied :

Do you think that if it were a tumor symptoms would have progressed after all this time? Can migraines cause just one lesion to form? My neurologist never mentioned that migraines can cause lesions on the brain.

Expert:  Dr. Sudhir Kumar replied 3 Days.

Thank you for getting back.
Yes, if it were tumor, symptoms would have progressed over time.
Migraine can form just one lesion. I am not sure why your neurologist dId not mention, but migraine is one of the commonest causes of while matter lesions on brain MRI.
Best wishes

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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