What does an MRI tell an MD?
 

I've now had two appointments with a concussion specialist - by all accounts an outstanding doctor (former neurosurgeon). He said that MRIs typically don't reveal anything in relation to a concussion, but he said it might be worth doing one just to cover all my bases. He said I didn't need to decide one way or the other right away.

Has anyone had an MRI following a "mild" concussion? What sorts of things might it tell a competent doctor? I would prefer to avoid being stuck in that tube for half an hour if I can help it...

He actually gave you a choice? Wow. I'm impressed by this doctor already.

My doctor had an MRI of my brain recently specifically to look for damage to the vestibular region of the brain. I think typically they are done to look for bleeding or more serious damage. They almost always come up negative for concussion. Actually, this is by definition I think -- concussions have negative scans. If something turned up, you have more than a concussion at the very least.

MRI's and CT scans after a concussion are done to look for and rule out an more serious injuries. Bleeds will show up on the 3rd day but usually not sooner. If they spontaneously stopped, they will be resorbed starting the 3rd day.

MRI's will not show the minute injuries from a concussion unless the MRI coil is a 6 Tesla or greater. The normal 1 to 2 Tesla coil MRI equipment does not have fine enough of a resolution. They will show a BB side item and sometimes down to the size of a grain of salt but nothing smaller. The diffuse axonal injuries common to concussion are much smaller. More like the size of a hair strand.

Doctors often use them to cover their own malpractice liability issues. The option is wise as it allows the patient to consider the financial cost. Insurance can also baulk at paying for an MRI that they deem is not medically necessary.

Getting stuck in that tube can be made much easier if you are prepared. I am claustrophobic but have successfully had many MRI's. The trick is to close your eyes before they roll you into the tube. Also, hold your elbows in tight so that you do not feel the sides of the tube. Now, think of something pleasant and spacious. They will give you ear plugs to help with the pounding noise. Use them.

But, as chitown said, a concussion without complications will result in a negative finding.

CT scan
 

My husband has been getting a CT scan every month since his m/c accident 3/9/2011. It is possible, like in his case, to develop CSF (Cereobral Spinal Fluid) in the frontal lobe where there was an injury to the brain or shift (my understanding). A month later, the CSF was absorbed by the body but because there was still a small empty space a vessel ruptured and left a small bleed. His neurosurgeon decided to monitor it ...

His next appointment is June 24, 2011 with a more recent CT scan on the 23rd.

milesa7,

Your husband's CT's sound like they have good reason to be repeated. You husband suffered a severe Traumatic Brain Injury. Most of the questions about MRI's and CT's are in regards to mild TBI's, concussions, subtle brain injuries and such traumas that had limited LOC (loss of consciousness) if any LOC at all and rarely any hospitalization.

It sounds like you husband's doctor is being very thorough. You are both very fortunate to have a good doctor. As he progresses, you will likely hit the recovery wall where he will have Post Concussion Syndrome like symptoms. The recovery process will likely slow down as he starts to deal with the diffuse axonal injuries that tend to become more chronic than acute and life-threatening.

Remember the good times you had just before his accident. You can tell him about these times and build from them, especially if he is left with a flat emotional affect like many of us are.

There can be a big difference between someone who is behaving poorly due to their own choices and those who have behavioral struggles due to physiological problems. We can choose to reject the negative behaviors when we acknowledge that our damaged brain leaves us prone to poor behavior.

I struggle to understand this myself. Before my most recent injury, I would defend my poor behavior. Now, I accept that I behaved poorly, especially when it is a symptom of my PCS and ask forgiveness then try to avoid the behavior the next time. The triggers for poor behavior are usually the same as the triggers for the head aches and cognitive struggles. Now that I know how to recognize the PCS triggers, I can be more proactive at avoiding them and the poor behaviors that may result.

I hope this is making sense. If not, maybe someone else has this same experience and can explain it better.

My best to you all,

When I had my TBI my symptoms are all concussion symptoms but when my PCP did the imaging (3 days later) it showed brain contusion (literally bruising on the brain). After that several MRIs and no more bleeding but showed minimal brain softening (encephalomalacia) and will show that rest of my life. Not that anything can be done for that but is just an evidence there was a mild TBI.

They can look at your vestibular system, sinuses and so many other things just to rule out and give you peace of mind. Sometime subtle CSF leaks can cause headaches etc., which may be able to fixed. Anyway the chances of all these are very less if it is a mild concussion. I didn't know I was claustrophobic until I got into the MRI. So next time my doctor gave me Xanax and sure I tolerated pretty well. By the way that is how I found out Xanax helped me with Dizziness too. As Mark mentioned close your eyes before you they slide you into the machine and never open until you get out. It is not that bad after that. They also talk to you during the whole process explaining what is going on.

When I had my TBI my symptoms are all concussion symptoms but when my PCP did the imaging (3 days later) it showed brain contusion (literally bruising on the brain). After that several MRIs and no more bleeding but showed minimal brain softening (encephalomalacia) and will show that rest of my life. Not that anything can be done for that but is just an evidence there was a mild TBI.

They can look at your vestibular system, sinuses and so many other things just to rule out and give you peace of mind. Sometime subtle CSF leaks can cause headaches etc., which may be able to fixed. Anyway the chances of all these are very less if it is a mild concussion. I didn't know I was claustrophobic until I got into the MRI. So next time my doctor gave me Xanax and sure I tolerated pretty well. By the way that is how I found out Xanax helped me with Dizziness too. As Mark mentioned close your eyes before you they slide you into the machine and never open until you get out. It is not that bad after that. They also talk to you during the whole process explaining what is going on.

When you say "flat emotional effect" what do you mean. If your wife was to up and leave, would it not bother you? If you were to watch a compelling movie which made everyone cry, would you not cry? Are you not emotionally attached to people, places, or things?

Sorry, I am just trying to understand why my husband is the way he is...he came home from work one day and walked right passed the bathroom without saying a word to me while I was getting ready. Seems like I'm living with a completely different person, who doesn't see me the way he used to.

I have the flat emotional effect that I assume he is talking about and I'm not sure if I can explain it to you. If I sit and think about my situation, I expect to feel something come over me that is saddness... I almost brace msyelf for it mentally but it never happens. It's as if that chemical I once had for feeling poorly about a situation i'm in, is simply not there. I haven't once felt bad about my mtbi. It's bizzare. You would think this situation would be depressing. In fact that's one of the first things each of my friends have said. "Wow, you must be so depressed and crazy that you can't workout!" Nope, not really! I simply do not care. Which is weird weird weird for me and they just don't know what to make of it. I live for my workouts and tHis is really a bad thing that happened to me, but I can't feel it. It's almost creepy.

This effect has been great in business. I find myself cutting to the chase better with people who work for me instead of worrying about their feelings... which is a fine balance of keeping them happy, I know that, but hopefully you get my point.

WHen it comes to family, however. If something were to happen to a family member. I think I would not experience it in exactly the same way but yes it would hurt deeply just as it should. I assume. I think something like that would likely just bring on a flood of PCS symptoms and stress.

My MRI didn't show anything concerning my concussion, but it did show a severe sinus infection.

I knew that I had had a cold, but my PCS had masked the other symptoms of what turned out to be a very severe sinus infection. My neurologist told me the bacteria in my sinuses was close to penetrating the skull and affecting my brain.

An MRI is nice just to rule out the other possibilities. It gives you less to worry about. :)