Abnormal MRI

MRI comment- calcified falx

by Calcified Falx
(Central US)

Chronic Migraine

I have chronic migraine and other diagnosed headaches. After the most recent MRI I was told was 'normal', but when I got the report it said there was 'calcification of the falx' and something about 'no cerebral atrophy visible yet'. Yet? Nobody told me about this - frustrating. Now my doc is moving and I need to find another so have no chance to question my current neuro.

This leaves me wondering what calcification of the falx could mean and what it might have to do with chronic migraines and my symptoms.

Answer

Hi,

First of all, calcification of the falx is a benign usual finding on many CTs and MRI's. The falx is that part of the lining covering the brain that folds inward between the two hemispheres. As a person ages, calcifications can collect in this area and is considered an "incidental finding" on imaging. It is not related to your migraines.

As far as the atrophy comment,you do not give your age, but that too could be put down to "ruling out" conditions. Many times when dictating a report, a clinician may state " no atrophy, no aneurysms, no evidence of white matter lesions". They are just noting that they looked for this and found none. Just so you know..we are ALL going to have some atrophy of the brain as we age (myself included!).

By all means discuss the report with your new doctor.

Hope this helps..
Mary Kay Betz MS RPA-C

Hi,
Can someone please tell me what an "Incidental are of calcification on the right side Cerebellum" means?
Does Incidental mean "not important"?
What does "restricted diffusion at the site of the lesion" mean?
Why is Neurology so confusing!?
I have had migraines for many years (I'm 35) but they seemed to have recently increased in frequency and severity plus ihave developed neurological symptoms so my dr ordered an MRI. I would really like to understand this calcification thing.

Thanks
:-)

Answer:

Hi,
Incidental means just that..they found it but it is not considered important. As we age we will all have calcification somewhere in the body.

You do not mention the size of the lesion so perhaps it was just a meningioma that you have had since childhood and it calcified. Diffusion restricted refers to an imaging term and without a degree in neurology you wouldn't understand this so try not to worry about it.

Talk you your doctor and ask him or her to explain the report fully.

Good luck..
Mary Kay

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abnormal ct scans

by Tina
(altoona, alabama)

Too many pills

I have had 2 abnormal CT scans; migraines are getting worse.

I have taken, maxalt, imitrex, depakote, treximet, relpax and nothing helps. I have had to go to clinics to get shots of phenergan with some pain meds and still it doesn't get rid of it. What can I do, my neurologist doesn't believe in narcotics and I don't mind but when one hits I want something to stop it. Please can you help me. They are controlling my life.

Answer:

Hi Tina,

You had mentioned in the title that you had 2 abnormal CT scans. This may be concerning in the presence of headaches that do not respond to regular migraine medications. I would consider asking for an MRI of the brain (with contrast) and an MRA to look at the arteries.

You do not mention any daily medication for prevention except Depakote. If you have not been on Topamax, Keppra or Zonagran they are worth a try. You need 90 days to determine if any medication will help. Sometimes headaches are so severe, none of the triptans (Imitrex etc) will work until you bring the intensity of the headaches down with daily medication.

Lifestyle is probably one of the biggest hurdles for most people when it comes to migraines. Managing stress, sleeping well and exercising REALLY does help. I am a migraineur too and if I don't watch the lifestyle..bam..here comes the headache.

It is important to do the medications, lifestyle changes and vitamin therapy all at the same time.

At this point if you are having such severe headaches that they are controlling your life, you need to see a headache specialist, not just a neurologist. In Alabama, the following doctors are specializing in headache:

Harry Lee McDaris, MD
Huntsville, AL

Gary Kilgo, MD
Northport, AL

It is worth the drive or travel to find the right doctor..once your headaches are under control your doctor can take over the management.

Your neurologist is right about one thing, narcotics are not the answer as we don't use them in our clinic either.

Good luck!
Mary Kay Betz MS RPA-C

COMMENTS:

I am a BSN working on my nurse practitioner's license. I will turn 50 this year. I have suffered with migraines since I was 18. I saw a holistic doctor last year. He told me that 90% of the patients he sees with migraines have a low magnesium level. He did a complete blood work-up, and BAM... my magnesium was extremely low. I have been on supplements, and I have had two migraines without the aura in a year. This is compared to at least one a week, and scattered headaches. Look at the theraputic level of the blood, not the clinical levels. The theraputioc levels are more accurate to what your body needs.
MB

Hi,
I am glad that your headaches resolved with magnesium. Those of use in headache management have long known that most migraineurs are deficient, that is why we place them on supplementation. I usually recommend Magnesium Oxcide 600-800mg per day.

IV Magnesium is also excellent to break a bad migraine. We use 2.0grams in 250cc NS over 30 minutes and it works well.

Although you had lower serum magnesium, this usually doesn't happen which is why I tell patients I don't bother testing them. Serum levels do not correlate well to CSF levels.

Good luck in school!

Mary Kay

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