Are these holes in my MRI normal?

[tjs86]

I just had an MRI of my brain and cspine. I'm trying to get in with my neurologist sooner but he's only in the office one day a week. I am only 24 and originally was referred to him for headaches. At my appointment though he said my reflexes were brisk and wanted to do an mri to check for damage or disease to the spinal cord/column (myelopathy?). Well I googled and saw that this could be a symptom of MS. And as I saw other symptoms, several of them matched up with what I've been going through for a few years now. I mean nothing major, mainly cognitive problems. I have a horrible memory and I'm always forgetting things and words or using the wrong words or saying words in the wrong order. And I forget things I shouldn't like how old I am or when my birthday is. Anyways I am an impatient person anyways so I decided to look at these MRI images and I can't really tell anything of course but I noticed these....holes. Theres really no other way to describe it. I googled again and saw the whole "black holes" thing with MS and also something about TIA's or strokes. But is it possible these holes are normal? I didn't see any bright spots that looked like ms lesions. I removed my info and uploaded the images to flickr. I thought i'd post them here so you could see what I mean. I know you aren't doctors but since many of you have been through lots of mri's and tests I thought maybe you could provide some insight. I'd really appreciate any help you can give. Like I said I'm only 24. And I'm not "worried" about an MS diagnosis persay because it would almost be a relief as to why I have such a hard time with things and I'd certainly rather it not be strokes cause to me that sounds scarier. Thanks again. Oh and here are the images:

http://www.flickr.com/photos/42931537@N07/5013875881/sizes/l       (in the picture on the left i highlighted a whole section that kind of look more like pin pricks than holes...)

http://www.flickr.com/photos/42931537@N07/5013875807/sizes/l


I guess I may as well post these too. I think they are just some kind of blood vessels but I could be wrong and again you guys may have a better idea. This is a view of the upper cervical spine:

http://www.flickr.com/photos/42931537@N07/5013660439

http://www.flickr.com/photos/42931537@N07/5014266734

[jensequitur]

That's true, but you are in Australia, and things are a bit different over there.

[JemmAus]

You know I've had 4 different neurologists and 3 different radiologists not agree on my MRI results.  As a results, I don't know who or what to believe about anything. Seems to me degrees in medicine are no guarantee of knowing what you're talking about!

Half the time it seems they will skip studying your scans properly if you had them done just before lunch or at 4.30 pm on Friday. Things to do, places to go etc, quick look, and be gone.

I am collecting new MRI scans this afternoon. They are comparing old scans to new. I deliberatly dit NOT include the old radiology report, because I am very VERY interested to see yet another radiologists "opinion" on my scans.......

[jensequitur]

Sorry if I sounded harsh - but I'm quite serious about not looking at your MRIs too much, or trying to interpret something you don't understand very well.  That's not a slight on anybody.  

Radiologists go to school for a long time to do the job they do.  Unless you've gotten your four year medical degree, then your two year radiologist degree, then it's best to leave it up to the professionals.

[Audrey_M]

Sorry to hear your headaches are so bad. I'm going to paste a link that is very comprehensive about different types of headaches and possible causes:

http://www.ninds.nih.gov/disorders/headache/detail_headache.htm

Its quite long, but very informative. It may help you to be able to describe your headaches. They recommend that you keep a journal.

The other thing that I found very interesting is that medications need to be specific to the type of headache. So if you are not getting relief from normal painkillers, both OTC and scrip, it would seem that your headaches fall into a different category and require some other type of medication for relief.

I hope you start keeping some kind of journal. With something like this, I find a spreadsheet or a column format works best. It will be invaluable to your doc and you in finding the cause for these terrible headaches.

Hope you get some answers soon.

Audrey

[tjs86]

Ouch. That was a little harsh. :-(

[jensequitur]

Personally I think that it's a mistake to look at your MRI!  Without a lot of experience, you're going to see things that you think are lesions which actually aren't, and miss the stuff that's actually going on.  What is it Quix said?  "A person who reads their own MRIs has a fool for a radiologist."

A radiologist is highly trained in looking for abnormalities.  They will look at the entire MRI from bottom to top, not just the stuff that looks 'clear.'  

[tjs86]

I was wondering...when they are looking at the spinal cord for lesions do they only look at one slice, the most clear? Or can any of the images of the spinal cord be used to check for lesions even if the cord isn't the solid dark color? I have 3 images total of the spinal cord and a few others where its total skewed so obviously you wouldn't use that to check for lesions but of the 3 clear ones; two the spinal cord is pretty solid from a little sac looking thing all the way down to the end of the image just one is tiny bit clearer than the other. And the 3rd image you can't see the cord connected to a sac up top and lower down in the image theres a long brightish spot there that "interrupts" the spinal cord. This is on a t1. On the t2 that spot shows up as a dark spot. Am I correct though in assuming they would only look for lesions on the first two images where the cord looks clearest and most normal?

[tjs86]

Oh I did forget to answer part of your question. The pain is nearly constant. Sometimes I wake up without a headache but after a few hours it's back. The pain doesn't change except for getting more intense and for when those straining movements cause sharp stabbing pains.

[tjs86]

I know what you mean, those standard words they use don't really describe my headache either. Except for sometimes when I laugh, bend over or have a BM I get sharp stabbing pain in the front of my head which is also the general area where my head hurts. Theres no word, other then those severe pains, to describe besides "it just hurts."

I do get pain in the back of my head and neck area but I had a neck injury in 2008 and that feels completely separate. I did do some research and have been wondering about post traumatic headaches. I just feel stupid bringing stuff up to the neuro. Like I'm not in the medical field or anything and I don't wanna look stupid. And I'm not sure if the post traumatic headaches fit the cognitive symptoms though.

But back to the headache, it was so bad one night I just wanted to die. I'm not depressed (right now anyways) but the pain was so bad and I've had a headache every day for like 10 weeks. I couldn't take the pain anymore. I went to the ER and got a shot of morphine. It took the pain away for a few hours but as it wore off the pain came back albeit not quite as bad. I have tried so many medicines though. Ibuprofen, tylenol, excedrin migraine, maxalt, midrin, vicodin, dilaudid and of course the morphine. Now i'm on topamax to try and prevent the headaches. Not working so far but I think it needs time to build up in my system so I'm trying to hold on to a little hope.

*sigh*

[steph74]

You can call your neuro and ask for the report to be faxed to you before you see the doctor.

I've had a lot of problems with severe headaches that aren't typical migraines or cluster headaches or anything like that.  Can you describe what your headache is like?  Where is it?  What does it feel like?  Is it constant?  Does the type of pain change or is it always the same?  

Just describe it however seems easiest to you, don't worry about the words dr's ask about.  I described my headache partially as being hit in the back of the head with a baseball bat; a huge jolt that shocks my head.  (In other words, "pounding," "sharp," "dull" etc., didn't really describe it at all.)

Stephanie

[tjs86]

Oh and Jemm, I don't have the report. They were just sending it to my Neurologist. I wont find anything out till I go back to see him.

[tjs86]

Thanks everyone. Its good to know that these holes are normal. I thought they looked too much like actual holes to be the "black holes" i read about but I wanted a second opinion :)

I'm afraid my MRI is going to come back completely normal which is a little disheartening. My headaches are so bad and they don't respond to any medication. And the cognitive problems are getting to be ridiculous. I was filling out paper work earlier and spelled fail, fali.(Of course I can spell "fail" fine now. grrr) If they headaches are just headaches well thats good I guess. It doesn't help anything since I'm not getting relief from them though. And I don't really know what to do about the other issues. I'm just at a complete loss :-(

But thanks again everyone. I'm sorry for what you all are going through too.

[jensequitur]

Yeah, these are normal vascular holes that are actually blood vessels.

Hey, take a look at my most recent MRI pics - they're on my profile.  I have the MRI report posted for the brain and spine, so you can see the results, then see what the radiologist said.

[JemmAus]

What does the MRI report say? (if you have that...)

[tjs86]

Oh and I didn't highlight every single hole. I think there are a few single ones around the "edges of the brain". I'm not sure. Its hard to tell. Just wanted to add that....