Headache and Migraines Forum - MRI for migraine headache

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Q: MRI for migraine headache

asked by: SkipM2 on March 29th, 2008

New User

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.

Mild pansinus mucosal thickening
****************************************** *********the end*************************************** *************

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.

Replies(4)

SkipM2

replied on March 29th, 2008

New User

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?

antigone

replied on March 31st, 2008

Extremely eHealthy

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.

SkipM2

replied on March 31st, 2008

New User

Thank you

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

antigone

replied on March 31st, 2008

Extremely eHealthy

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.

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