MRI for migraine headache Posted: 03-29-08 10:18am
My wife and I have only Google to
interpret and it is driving us nuts.
Please help with some educated thoughts in
regular English. Thanking anyone in
advance:
My son has had migraine headaches, as I
did when I was a child for over a year
with great frequency (2-3 times per week).
We have been trhough hell with scheduling
an MRI, 1st Pediatric Neurologist said no,
just CAT and EKG, so we moved on after the
EKG nurse told me we should have more kids
"just in case" and in front of my son.
He is fully functional, nothing other than
the headaches, top grades etc. Here is the
result from his MRI and we cannot speak to
his new Neurologist until April 8th. We
were told by the assistant he was fine,
nothing on MRI, then she called back the
next day crying and apologizing that she
looked at the wrong records. Anyway, here
it is - Please help with some thoughts:
******************************************
*beginning of
report*************************
Sedation (although he looked like was
still he apparently wasn't, they sedated
and machine broke down in the middle so
MRI took ~ 2 hrs) : Robinul .12MG IV
-Versed 5.2 mg IV Nembutal 200 mg IV
Technique: Muliplanar sequences of the
brain were done with and without contrast.
Findings: No prior studies are available
for comparison. Multiple focal areas of
increased T2-weighted signal are seen
throughout both cerebral hemisperes being
more prominent in the right frontal lobe
white matter and also in trh
frontoparietal subcortical white matter
superiorly. Largest lesion measures 1.2cm
and is seen the left perirolandic
subcortical white matter. No pathological
enhancement is seen. No lesion is seen in
the basal ganglia or posterior fossa.
Ventricles are normal in size
Mild bilateral maxillary, ethmoid and
sphenoid mucosal thickening is seen.
Conclusion: Multiple bilateral cerebral
hemisphere white matter lesions as noted.
Differential diagnosis includes areas of
demyelination versus gliosis. Clinical and
labaratory correlation is recommended.
Follow up MRI is recommended.
Finally as a note to Neurologist #1 CAT
scan and EKG - He stated that my son has a
pineal cyst ~ 1.2CM that was not picked up
on MRI but note the lesion size on largest
lesion is same.
Due to Neuro # 2 vacation, we have to wait
until April 8 to learn what this means.
Please advise now as my wife and I are
obviously worried plus searching Google
only makes it worse.
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SkipM2
New User, Becoming EHEALTHy
Joined: 29 Mar 2008 Posts: 3
Posted: 03-29-08 18:43pm
So, can I assume this MRI report is beyond
help on this site for interpretation? As a
newcomer I thought there were people in
the know that would offer some insight
without fear of liability/ Am i wrong on
this?
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antigone
Supporter
Joined: 27 Jan 2008 Posts: 998 Location: IL
Thanks: 49
Thanked:18
Posted: 03-31-08 00:37am
I don't fear liability and I am no expert
in interpreting the findings but what I
read is that your son's MRI is showing
lesions in both hemisphere (sides) of the
brain. The differential diagnosis is
saying that it could be a demyelinating
disease such as multiple sclerosis.
Gliosis is a proliferation of astrocytes
(a type of glial cell in the brain).
Gliosis can be due to central nervous
system diseases - again multiple sclerosis
is suspect. Pineal cysts are fluid filled
and may not lead to any problems if they
are small and there are no symptoms. The
pineal gland is at the base of the skull.
The problem with pineal cysts is that they
can cause pressure into the ventricle (a
space in between brain tissue that holds
cerebral spinal fluid) and cause
hydrocephalus (accumulation of cerebral
spinal fluid due occlusion in the
ventricle). The cyst can, also, put
pressure on the brain tissue and will
cause neurological symptoms. Headaches can
be a symptom of a pineal cyst.
The above is what I read from the report.
No guarantees on the accuracy of my
interpretation. You need to see a
neruologist or neurosurgeon to interpret
this.
I would try to find another doctor. Go see
a pediatric neurologist. Do you have a
children's hospital near you? Usually a
children's hospital will have a
neurologist on staff. I would call and get
the nurse on the phone and tell her what
the MRI says in the Conclusion of the MRI.
Mention the pineal cyst and your son's
headaches. This may get you into see
someone sooner. I would bang on every door
I could.
Let me know what happens with your son. I
am a neuro ICU nurse. You can pm me if you
like with other questions. All the best
and my thoughts are with your family.
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SkipM2
New User, Becoming EHEALTHy
Joined: 29 Mar 2008 Posts: 3
Thank you Posted: 03-31-08 04:43am
This is the closest thing to a real answer
from anyone for a week. Both 1st and
second neuro's are pediatric neurologists,
and current and 2nd one is with Miami
Children's Hospital - Dan Marino Center.
We keep seeing MS although headaches are
only symptom vs numbness or joints and
seem to be better controlled by Vitamin B2
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antigone
Supporter
Joined: 27 Jan 2008 Posts: 998 Location: IL
Thanks: 49
Thanked:18
Posted: 03-31-08 08:47am
I would think the headaches are associated
with the pineal cyst as opposed to the
lesions seen in the white matter. The cyst
can cause hydrocephalus and this would
cause a headache. The headache may be
migraine in nature as well.
MS presents with weakness in the legs.
Many people report tripping over nothing,
balance disturbances and clumsiness. There
can be some numbness but this is not
necessarily a presenting symptom. Think of
MS as a glitch in the nerve fiber. The
myelin sheath is a protective layer over
the nerves that helps with conduction of
nerve impulses up and down the nerve. The
myelin sheath develops a plaque on it and
the impulse is abruptly halted due to the
plaque causing interference in the impulse
traveling on the nerve. This interruption
in impulse is what causes the symptoms of
MS. The impulse can not travel smoothly or
as quickly on the nerve.
Another finding on the MRI was sinus
inflammation. The ethmoid and sphenoid
mucosal thickening suggest a sinus
infection or disease process. This may,
also, be the cause of your son's
headaches.
Call the 2nd doctors office and talk to
the nurse. Perhaps another neurologist can
see you sooner if you are concerned about
waiting another 10 days.
I am sorry it took so long for someone to
answer your querie. Let me know what
happens with your little boy. Feel free to
ask any questions. I can always look up
what I don't know. I hope this helps you
with understanding the medical
mumbo-jumbo.
