headache

[marissa206]

My son, 11 years old, starts having frequent headaches since January 2008 after sick for one week in which he had fever, headache, sleepiness, and flu-like symptoms. The headache is worse with physical activities such as running, wrestling and play basketball. The pain is mild to moderate and located on the back of his head. The pain lasts from 30 minute to 2 hrs. He has no change vision, nausea and vomiting.

He had his MRI and MRA two weeks ago. His MRA report is normal, but I am not sure about his MRI findings. Can doctors explain the findings for me and what we should do next? We live at a small town and take months to get an appointment with a neurologist. Your help will be greatly appreciated. Thanks.

Here is the MRI report:

Findings:

The ventricular system is normal in size, shape, and configuration. There are no intracranial mass lesions, and there is no mass effect, or midline shift. No abnormal fluid collections are identified. The cerebellar tonsils terminate at the level of the foramen magnum.

There is a tiny focus of high T2 signal in the right parietal white matter, nonspecific in nature. There are no other areas of abnormal parenchymal signal intensity on these sequences.

There are no areas of abnormal enhancement following contrast administration.

A tiny pineal cyst is of no clinical significance.

The visualized major intracranial vessels appear patent. No definite abnormality is seen in the visualized portions of the orbits. The middle ear cavities and mastoid air cells are clear. There is trace mucosal thickening in the ethmoid and sphenoid sinuses.

Impression: ?

[marissa206]

Hi Dr. Deshmukh,

Thank you very much for your help.

[Abhijeet Deshmukh, MD]

Hello.

The only positive findings were the lesion in the parietal lobe and the mucosal thickening of the sinuses mentioned.

The lesion in the parietal lobe may not be clinically significant at all. Te MRI has not mentioned if this is an old lesion or a new development. But I guess, it may have come from the illness he recently had. It will be premature to say whether the headaceh is caused by the lesion.

The sphenoid and ethmoid sinuses have thickening of their lining mucosa. This can be significant as far as his headaches are concerned. These are signs of inflammation due to a number of reasons. He may have had infections of the upper respiratory tract.

Regards