Has anyone had a brain MRI while on venetoclax or rituximib ?

[Moggn]

I began to relapse CLL early 2021, started treatment on venetoclax Aug 2021 and then 6 X monthly rituximib infusions.

In Mar 2022, a month after the last infusion ,( after a bit of nausea over the previous couple of months) I had BAD nausea in the night then two very brief faints/blackouts, then vomitting, so off again in the morning to get this checked out .

I have cardiologist (due to a "mild" heart attack and subsequent Afibs after FCR a few years ago), who thought it wasn't a heart related "faint' as i seemed to have just settled to the floor as distinct from a damaging "splat". He did tests and couldn't find any issue but was concerned to find an answer.

He called in a neurologist who ordered an MRI which showed 'nothing that would have caused it" BUT did show an "interesting feature, that I don't need to be concerned about". This was (from the report) a "subtle signal abnormality along area postrema". He repeated , that its unusual in older people, wouldn't have blacked me out, not to be concerned.

My haematologist called his contact about possibility of the brain thing or blackout being a side effect of ventoclax and was told he hadn't heard of anything like this.

So, undiagnosed and so with an untreatable problem, I was advised that, the road rules here are that, sorry, I mustn't drive for 6 months and I was discharged with an appointment for another MRI and review with neurologist in 3 months.

The followup MRI is all clear !! That is obviously a good thing and a great relief 'cos despite the "not to be concerned " from the neurologist earlier its really difficult not to get pretty stressed about abnormal features in ones brain ! He doesn't know why it happened so no real idea why its gone.

Googling was a bit alarming - problems in that "area postrema" are common in MS and ongoing Nausea illnesses and the language of neurology is more complex/difficult than of blood cancers.

My case apparently is/was like an inflammation in that area. He thought my theory that the inflammation might have been a response to one of my treatments was likely , and that triggered worse than usual nausea - but not caused the falling down !

I'm interested in whether anyone else has had a brain scan and seen anything like this . ?

PS Due to covid precautions we haven't been going anywhere much anyway , but wife is a fine and uncomplaining driver.

[JigFettler Volunteer]

I had a brain MRI for new visual migraine after FCR in 2019.

iv contrast, 45 min rest, easy. Important to keep still though. No claustrophobia.

Driving... a pain. Its an insurance issue. Stick to the rules!

Good yr MRI was OK. Wonder if you had low blood pressure?

Jig

[Moggn in reply to JigFettler]

Thanks Jig.Yes, my BP is OK, I wore a monitor for a couple of days and did a lot of sit to stand checks.

And yes, I'm sticking to the rules. Altho there have been no more incidents, and the nausea is gone it seems a sensible rule to be pretty confident that it was a one-off.

I hope your migraine problem is gone or controlled.

best wishes L