Is it a migraine?

[Jen60]

I am a 38 year old. I had an MRI recently due to severe stabbing pain on the left side of my head. It appears without warning, only lasts a few seconds and after it is over I am exhausted. The results were 6 small foci the largest 7mm in diameter that have abnormal signal in the white matter of the cerebral hemisheres best seen on the FLAIR sequence. They listed 5 or 6 possible causes. One is migraines. My doctor thinks that is the answer. I have suffered with migraines since childhood and these pains are nothing like my migraines. My doctor doesn't seem to think it is a big deal but I am wondering if I should see a neurologist anyway. Am I over reacting?

[Dr_Smita_S]

Hi,

I do not think that you are overreacting as it is normal for a person to be concerned about lesions noticed on the MRI scan. Also, any change in the type of the headache should be investigated to find out the cause.

Although it is difficult to comment without looking at the MRI scan, I think that these could be white matter lesions (WMLs) which are seen more often in migraine patients but their association with migraine is not understood. Some changes in white matter are seen in migraine patients (especially in migraine with aura). They may also be present in asymptomatic patients, but their infarct-like nature is strongly suggested.

You should consult a neurologist for further evaluation and to rule out causes of such lesions such as ischemia, multiple sclerosis, central nervous system vasculitis, and other presence of different vascular risk factors.

Do write in about your neurologist’s opinion on these lesions.

Regards.

[retz225]

I have a question....what exactly can an Eye Dr.evaluate? I know an Mri would be the best source but can an Eye Dr. detect something else going on?