Spinal Tap type headache, but w/o the Spinal Tap:(

[gabalexmumma]

MRI from May 11, 2009 had this to say:

FINDINGS:

A linear vertical area of abnormal T2 signal is again noted in the upper cervical cord at about the C1-C2 level and foramen magnum. Obtaining an accurate measurement is difficult. The vertical height and the horizontal width may be perhaps slightly increased. Thinning of the adjacent cord in this area is seen. Important note is made of interval increased stenosis at the foramen magnum. This finding is felt to be related to the abnormal appearance of the superior odontoid. A large bony fragment is noted just posterior to the anterior arch of C1. Increased T2 and STIR signal is noted between this fragment and the remainder of the mid and lower odontoid. This suggests a pseudoarthrosis at this level. The relationship of the bony fragment in relation to the odontoid is more vertical in
orientation when compared to the prior study. This produces increased stenosis at the foramen magnum. The appearance of the odontoid may be related to an old fracture incidentally of the fracture fragment.  Alternatively, it may be related to an os odontodium with instability of this bony fragment in relation to the mid and lower odontoid.
Neurosurgical consult may be appropriate in this case. Also apparent is a focus of decreased T1 and increased T2 signal within the posterior midodontoid. This appears to be mildly enhanced with contrast. The overall size and appearance of this lesion is not appreciably changed. This finding is not typical of a vertebral body hemangioma. It is
indeterminate. It could conceivably represent atypical hemangioma given the stability. Continued surveillance may be appropriate. Also new in the interval is an area of abnormal STIR signal within the cord at the level of C6. The patient apparently has the diagnosis of multiple sclerosis. This finding is nonspecific, but it certainly could be related to multiple sclerosis. Correlation with patient presentation may be appropriate. No other evidence of a cord lesion is seen. The posterior fossa is unremarkable. An MRI of the brain was not performed. An equivocal focus of increased T1 and T2 signal is demonstrated in the T1 vertebral body. This may reflect a vertebral body hemangioma. The vertebral body heights and disc spaces are well maintained. No other evidence of marrow replacing process to suggest neoplasm or acute trauma is seen. The paravertebral soft tissue swelling is normal. No other evidence of abnormal STIR signal is seen.

      At the C2-3 level, no evidence of significant disc osteophyte pathology is demonstrated.

      At the C3-4 level, no evidence of significant disc osteophyte pathology is demonstrated.

      At the C4-5 level, a mild central disc osteophyte complex or tiny protrusion is demonstrated. The neuroforamina are widely patent.

      At the C5-6 level, a central to slightly right paracentral disc osteophyte complex or small protrusion mildly effaces the anterior thecal sac. The neuroforamina are widely patent.

      At the C6-7 level, a mild diffuse disc osteophyte complex is demonstrated.

      At the C7-T1 level on the sagittal images, no evidence of significant osteophyte pathology is demonstrated. In the upper thoracic spine, no other evidence of sign disc osteophyte pathology is demonstrated.

IMPRESSION:
      1. ABNORMAL FINDINGS AT THE C1 AND C2 LEVELS SUGGESTING INSTABILITY AND
      INCREASED STENOSIS AT THE FORAMEN MAGNUM.
      2. ABNORMAL LESION IN THE CERVICAL CORD AT THE LEVEL OF THE FORAMEN MAGNUM
      SUGGESTING MYELOMALACIA AND CORD ATROPHY.
      3. NEW ABNORMAL LESION IN THE CERVICAL CORD AT THE C6 LEVEL.
      4. VERY MILD DISC OSTEOPHYTE PATHOLOGY OR SMALL PROTRUSIONS IN THE
      MIDCERVICAL SPINE, AS DESCRIBED. SEE ABOVE DISCUSSION OF EACH LEVEL.

I had this MRI done because I was experiencing neck pain and an unusual urge to snap my neck to one side.  I at first attributed it to a weird MS symptom, but after consultation with my Neuro, sought the advice of my PCF.  Because we noticed on a previous MRI from about 18 mos. previous that also noted the problem at the C2 level, she thought it might be best to do this Cervical MRI.  After these results came back, she called me, told me the results, and I was immediately refered to a Neurosurgeon.  W/in one month I was in surgery to fuse the C1-C2 with Songer cables and an iliac crest bone graft.  The surgery was succesful, and the Neurosurgeon says all is well with that portion.  However, in the last 3 weeks, I've had what I can only call a Spinal Tap headache (one I recall only too familiarly from my early MS diagnosis years), but this one has a couple of twists.  I also have severe spasms mostly situated on the right side of my neck leading up to the right hand crown of my head.  I've also started experiencing vertigo and right arm numbness and pain.  As with any spinal tap type headache, laying down will almost immediately calm down the pain, but obviously that is not practical.  I have contacted my neuro.  He states that there is no reason for me to have this headache, take advil and that's it.  Any advice where I might find other thoughts?