Radiology/Brain MRI/Daily Headaches
Hi Dr. K. I suppose I should give you a bit of history, then my questions. First, I am followed every year with MRI's for what the radiologists say is likely a "benign entity" located in my sphenoid sinus/clivus region. It's been 10 years with no change. Second, I have suffered from headaches for years now (approx. 9 - 12 headaches per month) but recently have been getting them daily (37 days straight). The headaches are probably unrelated to this sphenoid thing so I have 2 things going on. My last routine MRI with contrast was done in April 2015. My family MD refused to send me for any scans (due to my headaches), since I had one done 7 months ago. I picked up and travelled to the U.S. (I am Canadian) and paid for an MRI to rule out any brain tumor or growth with the existing "entity". I did not have the contrast. No tumor or growth was found. Headaches are still there and family MD is now on board and willing to rule out unruptured aneurysm (too bad I didn't think about that when I went to the U.S.) So here are my questions:
1)Would my recent MRI w/o contrast pick up an unruptured aneurysm?
2)Would it be reasonable to think an aneurysm would be seen on my previous MRI with contrast 7 months ago - if on the referral it states "routine follow up on entity in sphenoid/clivus region", would they even look at everything else going on in the brain?
3)Will a CT scan with contrast be sufficient to rule out an unruptured aneurysm? CT can be done much quicker here in Canada.
4)I have a vacation planned with my family in 12 days and want to rule this out before I leave - do you have any idea if it is safe to fly with an unruptured aneurysm. I can't seem to find this answer anywhere (no neurologists on this site to ask).
5)I have all my MRI scans - if I can manage to upload them, would you be able to have a look?
Sorry for the long post. Wish this were simpler.
Question 1: No MRI of the brain w/o contrast will not pick up an aneurysm unless it is big (which is obviously not the case or someone would have mentioned it)...
#2:Yes we look at everything on the scan not just for reason in the request...but again brain MRI is not the study to look for aneurysms.
#3: CT scan with contrast is a good screening for aneurysms. The best way is to have a CT with contrast in the arterial phase (it has to do with timing when the contrast is injected and when we scan to get images. It is called CT angiogram of the head and it is probably the best test for to look for aneurysms.
#4: Regarding vacation... I would not assume that you have an unruptured aneurysm and change your life. It is one of the many many reasons...and I doubt you have it. Usually, headaches from unruptured aneurysms are from an aneurysm that just leaked a little and then stopped...which does not fit with the long standing headache history that you provide.
I may be able to look at the images...if I don't have to set up accounts with the services that you use. However, I can't promise that I will get to it quickly.
I would also recommend that you see a neurologist for your headaches
Hope this helps.