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Conditions and Diseases > Brain and Head Injuries Forum > Open vs. Closed MRI for brain scan
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Q: Open vs. Closed MRI for brain scan
asked by: Culturelady on October 22nd, 2009
New User
Two nights ago, I fell walking my dog. The sidewalk was off level. I had cuts on my knees and hands, and I hurt my hand when I tried to break the fall so I wouldn't hit my head. I went to an afterhours clinic an hour after I fell, to see if I broke my hand. I also told the dr I had head and neck pain, but he said he didn't think I needed an xray, and that I would feel like I had whiplash the next day. It was much worse. The next afternoon, the pain in my head was relentless. I could barely drive, and had blurry vision. When I got home from picking my daughter up from school at night, I began to vomit. The pain was staggering. Today I saw a neurologist and he checked me out and wanted me to have an MRI of the brain, I believe (I see that there is also an MRI for the head - does anyone know the difference?). He also wants me to have one of the neck since I have cervical pain. I was happy to do it, however, when the nurse went to book it, she told me I had to do it at the hospital (I wanted to do it at the radiology place I always go to). She said they wouldn't be able to get me in the radiology place in an emergency. I asked if it was an open MRI and she said no. I told her there was no way i could do a closed MRI as I am very claustrophobic. She said they could give me ativan. I told her they gave me 10mg of valium about 8 years ago to climb in one of those long outdated machines, and I just couldn't do it. Besides that, I'd have to stay in 1.5 hours she said as they would do both MRI's of the brain or head whichever it is and the neck. I know you have to have that basket on your head as well. We argued and i asked if I could do the open MRI (even that is a struggle for me), and she said absolutely not since it doesn't show images well. Huh? I had an open MRI recently for my abdomen, and it showed everything (and more than I wanted to know!). I told her to ask the dr, and she claims he said the same thing. I'm thinking that maybe the dr. is mandated to refer patients to the hospital he is affiliated with rather than an outside radiology center. She claims he likes the radiologists better at the hospital. I need to have this done as I have been getting other headaches from hypertension and cluster headaches as well.

To compromise, he is having me do a cat scan tomorrow morning, but he still wants the MRI's done. I had asked him the difference between a cat scan and MRI before all these issues presented, and he said the cat scan just shows dark images and costs $500 more. Well then why bother to do it? I think the better compromise would have been the open MRI.

I am glad I am having something done just to rule out a blood clot from the fall.

Any help would be appreciated. Thank you.
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motherofhighspiritedones
replied on October 27th, 2009
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A CT scan can show GREAT images of any signs of a brain bleed, which is probably why they want to give you one. An MRI shows details of the brain that a CT (or CAT) scan cannot pick up, such as the internal components of the brain (axonal injuries, medullar problems, aneurysms, pituitary issues, tumors, etc). It is normal to have both tests done, as each can provide different clues that assist with diagnosis. I disagree, however, with your doctor referring his patients to the hospital he is affiliated with, however this IS standard practice among many doctors. It is easier for them to go to the clinic or hospital where they work than to travel to an outside clinic.
An open MRI of the brain and cervical region of the neck is generally not advised, because, as the nurse and your neurologist stated, it does not show the images very well. To look at the abdomen with an open MRI is MUCH different than looking at the small and often complex details of the brain, spinal cord, etc. and there is a possibility that something such as a small tumor, could be missed. The machines are no longer considered "dinosaurs" (unless your neurologist has yet to acquire one of the newer and more accurate MRI machines) and, while I understand your fear and claustrophobic issues, I think it would be best to either get a second opinion from a different neurologist, or to just take the ativan and hop into the machine. After all, this is your BRAIN you are dealing with and if something is truly wrong, it is best to catch it before it becomes too late.
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