Chronic headache and MR venogram results

[cornbread33]

Hi doc. I was wondering if you could help me understand these results better. (note: I had a normal MRI brain/c-spine on 10-5-05, and a normal MRA brain/neck on 12-20-05)

brain MRV 1-09-2006, comparison brain MRI from 10-05-05:
Findings: The sagittal, transverse and sigmoid sinuses are all visualized with no evidence of compression. A focus of hyperintensity is noted in the right neck of unclear etiology. It demonstrates apparent flat border with the superior cervical internal carotid artery, vascular abnormality in the region cannot be excluded. However, MRA dated 12/20/05 demonstrates no abnormality in this region. Findings may represent atypical venous varix, recent vascular injury of the right internal carotid artery is also a consideration.
Impression: Unremarkable MRV. Focus of hyperintensity possibly associated with right internal carotid artery of uncertain significance. CT angiogram of the neck maybe helpful..

* Can this relate in anyway the the constant pressure I feel in my head? It's like a tension around my forehead, and it feels like there is a cord "dragging" my brain downward, like a distinct "pulling down" pressure type sensation deep in my head. It is constant, yet generally improves slowwwwly when laying down and gets worse thru out the day. I practically demanded an LP to verify the CSF pressure, but my neuro (headache specialist) absolutely refused to order it and more or less told me to get lost, and the only thing he would do is send me for neuropsych testing due to my complaints of "brain fog"

Doc, how does all this fit together? I am 30

[CCF-Neuro-M.D.-PW]

Its hard for me to comment on the MRI without seeing the images.

Even form the text description its impossible to visualize what they are talking about

In any case your headache does not sound typical for a headache caused by a tear in the carotid artery, which usually causes neck pain.
The concern about a tear in teh carotid artery is that it can form a blood clot and cause a stroke in the brain. If you do develop weakness or clumsiness on one side of the body, or difficult talking, go to the ER right away.

In difficult cases, a cerebral angiogram can help clear up the diagnosis.

Good luck

[cornbread33]

Of most concern to me, is that this finding wasn't there on the MRA from december 20th but was seen on January 9th.   (of course it was an MRV not an MRA, but still).