Brain MRI?

[Anonymous]

Would you want a brain MRI in these circumstances?
My teen has had really bad headaches for about a year now. They got worse after a concussion in late 2022. We saw the concussion clinic at children’s and they discharged her saying that continued headaches after so many months was not treatable under the concussion protocol and she should see a neurologist. We saw a neurologist about a year ago who gave her a prescription for migraine medicine and did an EEG which didn’t show anything really. The headaches are so persistent and really impact her quality of life. I know they try to avoid brain imaging for teens but at what point should they be checking to make sure it’s not a tumor or something? She also has frequent blackouts and has also seen a cardiologist who did a bunch of cardiac testing and recommended salt tablets.

[Anonymous]

Has your teen been tested for POTS?

[Anonymous]

Yes See if the neurologist will give you 2 MRIs. one with contrast and one without contrast. that's how they found my brain tumor

[Anonymous]

I have frequent brain MRIs. They are not dangerous and they can go from 20 mins to about 45 mins which is not a very long time.

I would absolutely, without hesitation get one in these circumstances.

[Anonymous]

I’ve never heard of them not being recommended for teens. I would get one asap and also investigate POTs. There’s a lot of data showing an increase in that after Covid in teens

[Anonymous]

I think an MRI would be better for diagnosis. POTS can be difficult to diagnose.

[Anonymous]

Anonymous wrote:I think an MRI would be better for diagnosis. POTS can be difficult to diagnose.

POTS is NOT diagnosed by a brain MRI.

[Anonymous]

Hi, I had a severe concussion in 2021. I got my severe (8/10) headaches almost completely resolved with counterstrain physical therapy. Any advanced counterstrain physical therapist can treat your daughter. You might call Chris Butler in Maryland ( Tuckey and Associates), Mary Beth Harrity in Alexandria, or Christine Wood in Waynesboro.

Make sure she’s wearing comfortable clothes and isn’t wearing hair extensions. The counterstrainers need access to her scalp to treat a head injury. Wigs and extensions prevent them from accessing the entire scalp, which means they might miss important drivers of her symptoms. Hair down or in a loose ponytail makes it easiest for them to treat the head. They will of course see you no matter how you’ve styled your hair.

Full disclosure, I’m related to a counterstrain PT, but they work in a nursing home, so I’m not directing your business to a relative.

[Anonymous]

In all of these clinics, you may be asked to see a lower level person to clear the easy stuff before going to see the best. Each of these practitioners could fill their day twice over, so while it doesn’t hurt to all, don’t be surprised.

[Anonymous]

Anonymous wrote:I’ve never heard of them not being recommended for teens. I would get one asap and also investigate POTs. There’s a lot of data showing an increase in that after Covid in teens

The cardiologist checked her heart rate lying down then standing up so I think that is the check for POTS, right? I may check that at home again a few times because other systems do seem similar.

[Anonymous]

Where are the headaches located? Any neck pain or are they exacerbated by coughing sneezing? My DD was released from a concussion clinic without an MRI. She continued to have dizziness, etc. Finally, she got an MRI and was diagnosed with Chiari Malformation. She also has mild POTs.

[Anonymous]

I would 100% get an MRI in this scenario. MRIs are not harmful (no radiation), I've never heard that teens should avoid them.

What cardiac testing did she get? Blackouts in a teen is concerning.

[Anonymous]

No, not necessary right now.

[Anonymous]

I'd probably pursue all of the options to rule things out - brain MRIs while not fun if you are claustrophobic aren't also at all risky - just laying on a table and no radiation. It's worth it if she doesn't mind the 30 mins it takes. You can request a wide bore at the MRI places. Have you done a full blood work up? Iron Panels? Vit D? Lyme? Washington Post had an excellent article yesterday on the increast in POTS in female teen athletes post covid.

[Anonymous]

Yes, absolutely. It’s standard care with headaches as a rule out. Don’t listen to the others saying no. Bad bad advice. It’s no big deal