Not sure what to make of this

General
1

Hey everybody!

Well, got my MRI report today after 3 days (I can pull up reports and whatnot on TricareOnline, but it takes about 3 days to show up), but I'm not really sure what to make of the results. Here's the quoted report findings:

"MRI the brain without contrast.

Indication: 28-year-old with history of migraine headaches with change in characteristic 8 months ago into a more chronic daily headache. Recent head CT and 5 mm cerebellar tonsillar ectopia. Normal neurologic exam by history.

Comparison: Noncontrast CT head 4/3/2014.

Sagittal T1, axial diffusion, Wen bold, T2 and FLAIR sequences are provided. The cerebellar tonsils have a rounded configuration with the tonsils extending 4 mm below the foramen magnum consistent with cerebellar tonsillar ectopia. No significant crowding at the foramen magnum is demonstrated. The odontoid has normal size and configuration. There is no evidence of ventriculomegaly. The cisterna magna is noted to be small. The visualized upper cervical cord to the lower T2 vertebral body level demonstrates no obvious syrinx. The sulci are symmetrical with no intra-axial or extra-axial masses or pathologic fluid collections and no evidence of mass effect. The ventricles are midline in location. There is a single T2 FLAIR hyperintense focus in the left frontal lobe adjacent to the left frontal horn measuring 6 x 7 mm in size. This is nonspecific. The brain parenchyma demonstrates no additional signal abnormalities. Expected flow voids are seen in the major vessels at the base of the brain. Diffusion sequence demonstrates no acute ischemia. The corpus callosum, pituitary gland, and brainstem are unremarkable. The orbits and sinuses are unremarkable.

IMPRESSION: 1. Findings consistent with cerebellar tonsillar ectopia without convincing evidence of Chiari 1 type malformation. 2. 7 mm nonspecific T2 white matter hyperintensity in the left frontal lobe. This can be seen with sequela of migraine headache, diabetes, hypertension, and prior insult from vascular, metabolic or posttraumatic etiologies as well as demyelination. Consider progress MRI in 1 year's time for surveillance."

I have some prior experience in the medical field, but nowhere near enough to wrap my head around what to make of this. Any thoughts?

2

What I don't really get is the fact that my CTshowed 5mm, but the MRI showed 4mm, then the fact that that the radiologist says there's no "convincing" evidence of Chiari I malformation... I'm thinking the military medical system in general might still be stuck on the old definition, which wouldn't surprise me one bit. I worked in the medical field in the Army for over 6 years, and believe me, it is not the "best" as it is claimed to be. I'm somewhat debating self-referral to the Chiari Care Center in Aurora, Colorado (I live in Colorado Springs) and getting another opinion... I haven't decided yet.

3

Hello Liaspyre31! I would just like to encourage you to get a second opinion. If you can try and find a NS that specializes in chiari. Sometimes you have to see multiple NS before you find the right NS for you so don’t give up. Best wishes to you take care!

4

Thanks for the helpful advice, Emmaline. I've heard that Dr. Oro is one of the best when it comes to Chiari. I still need to follow up with my neurology PA about the MRI results, but I'm already planning on getting copies of my medical records from when I first saw my PCP about this in March until now, as well as my CT and MRI on disc. All that's been done for me so far is making some medication adjustments, which has somewhat helped, but not by much at all, and in some ways has made things worse. I just hope that I can get to the root of the problem soon, whether it actually is the Chiari or something else.

Thank you too, Lili, for the advice and encouragement.