Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 02-03-2014, 08:47 PM #1
YellowBird YellowBird is offline
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Originally Posted by Mokey View Post
My new doctor has ordered a new MRI wih DTI and something else. A more detailed MRI I guess. My first one was clear.
You are really getting an MRI with DTI (diffusion tensor imaging done) done?
I didn't know those are available apart from research yet. They can show structural changes in the integrity of white matter happening after concussion (which is not possible to be recognized with standard MRI).

There are studies that could show structural changes in the white matter 1 year after the concussions happened.

I don't know what the "something else" you mentioned could be. As far as I know DTI is already the cutting edge technology in current magnetic resonance imaging (MRI) technology regarding brain injuries available.
Please keep the board updated when you have had the imaging and know more.

Best wishes to you and the thread starter!

Last edited by YellowBird; 02-03-2014 at 09:09 PM.
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Old 02-03-2014, 09:18 PM #2
Mokey Mokey is offline
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Quote:
Originally Posted by YellowBird View Post
You are really getting an MRI with DTI (diffusion tensor imaging done) done?
I didn't know those are available apart from research yet. They can show structural changes in the integrity of white matter happening after concussion (which is not possible to be recognized with standard MRI).

There are studies that could show structural changes in the white matter 1 year after the concussions happened.

I don't know what the "something else" you mentioned could be. As far as I know DTI is already the cutting edge technology in current magnetic resonance imaging (MRI) technology regarding brain injuries available.
Please keep the board updated when you have had the imaging and know more.

Best wishes to you and the thread starter!
Hi again! I remember now...the MD (neuro-opthamologist) ordered the DTI and SWI. He is new to my city so hopefully the hospital knows what he is talking about! My GP was not aware of those types of MRIs!

I am not in Florida but saw that this place offered the DTI and SWI:
http://www.universitydiagnostic.com/...in-injury.aspx

The other MRI that can show something is the functional MRI. I have not had one, and was interested in pursuing that avenue but a friend who researchers fMRI at a university said it may not give me any info. that I can use at this time. In other words, if it shows my brain is not normal, how do I know that it wasn't abnormal to begin with (I should add he was a friend when we were teenagers and I haven't seen him since then so still has that mentality!)

Has anyone out there had the DTI or SWI MRI? fMRI? Perhaps we should start a thread on this?
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 02-03-2014, 09:21 PM #3
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Default a bit of humour

I just googled DTI and discovered that one of the MRI researchers in a lab nearby is called Dr. Frankenstein. Really.

Maybe she is just what we all need!
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 02-03-2014, 10:22 PM #4
YellowBird YellowBird is offline
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Quote:
Originally Posted by Mokey View Post
Hi again! I remember now...the MD (neuro-opthamologist) ordered the DTI and SWI.
SWI is an MRI sequence (like T2* is an MRI sequence, for e.g.) especially useful to detect blood.

DTI also does not need any changes to the MRI device itself, it just a software package, too, so actually it should be available. However, the ordinary radiologist does not perform DTIs yet.
If you end up getting one, maybe it would be worth sharing your experience here to others. Also it might be worth to start a thread on this topic.

However, the problem is that the imaging will not really give the patient a profit, as there is not a medical therapy, yet, which I do not need to tell anybody here.


Starr,
Sorry for sort of hijacking your thread. I suggest, if anybody has to share something about DTI, it will be better to do it a new thread.

Last edited by YellowBird; 02-03-2014 at 11:00 PM.
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"Thanks for this!" says:
Mokey (02-04-2014)
Old 02-04-2014, 02:57 PM #5
"Starr" "Starr" is offline
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I got a copy of the MRI report. They are comparing it to the CT scan I had 6 months after my injury. Its quite a long report, but the "important" paragraph was pointed out by my family doc, but seems rather vague and non committal.

"There is a single focus of blooming artifact in the mesial aspect of the left temporal lobe, at the level of the amygdala, not seen in the rest of the sequences. Given the patient's clinical history, this could represent a sequela of remote trauma / microbleed."

They also noted a "Single nonspecific focus of T2 hyper signal in the subcortical white matter of the left frontal lobe." But my family doctor said that's nothing to be concerned about, that every MRI shows that.

Embarrassingly enough, it also showed "a mild mucosal thickening of the left maxillary sinus, left sphenoid sinus ..etc".... I was just getting over a cold and had a snotty nose! Thanks for being so thorough!

Coincidentally, I just got called to brain injury clinic for tomorrow morning (thanks for the short notice!) so I'll see my physiatrist then.

While the MRI results might be slightly alarming to me and maybe interesting even... they don't answer the question of why my headaches have worsened since October and refuse to break and calm back down to a 5 or 6 instead of insisting at sitting at 8 or 9. I'm not even asking for *pain free* here.

And while its good there's not something extra terrible going on in my head, I just want a break from the head pain!

Starr
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Old 02-04-2014, 04:09 PM #6
EsthersDoll EsthersDoll is offline
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I had a severe, ongoing headache that stayed at 9/10 range for months. My neuro ordered a spinal tap and the headache(s) completely went away within 5 minutes and hasn't come back.

Maybe you should ask for a spinal tap?

Maybe you have an increase of intracranial pressure that isn't high enough to be seen on the MRI but can still be felt by the patient.
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Old 02-05-2014, 11:32 AM #7
"Starr" "Starr" is offline
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My physiatrist doesn't have much more to offer me... all the meds we've tried other than topamax have failed. (Various anti depressants, beta blockers, maybe others' I can't remember right now.)

For now we'll continue on with the once a week physiotherapy to keep working to try to improve the gait and balance issues... we were previously doing twice a week, but found that twice a week was not leaving enough recovery time between sessions, so we cut it back.

He's left me with some Ritalin that I can experiment with for the fatigue if I want and try to balance that with pacing strategies. I've not yet tried it. He gave me the script around the time my head pain went up and then I didn't try it as I didn't want to be tempted to over do it when my pain was already so high.

He's suggested I contact the opticalm.ca people to see about getting tinted lenses for visual issues.

My neurologist appointment is in July and then there should be more things to try... I know this particular neurologist does Botox for headaches and stuff and my physiatrist thinks I'm probably a likely candidate, so maybe that will be an option at that point.

Right now, when its currently snowing yet again and there's several feet of snow outside, its really hard to think about holding on until July for more options. Especially since I've already been holding on for 2 years now.

Kinda disheartening to feel like you just have to hold on indefinitely, with this level of pain, with no relief.

Esthersdoll, I have often wondered about a spinal tap... that would be something the neurologist would have to address.... in july.

I guess we just keep moving forward. That's what we do. Not like there's other options. But right now, this sucks.
Starr
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Old 02-05-2014, 05:52 PM #8
NormaW NormaW is offline
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Default Botox Injections

I just came back from an appointment with the neurologist. He suggested the Botox injections. They are done every 3 months and suggested 2 sessions before you could tell if there is any improvement.

The cost is $800 for the botox and $175 for the injections. He said some insurance will not cover the injection price.

He had discuss Topomax for headaches but apparently they can cause kidney stones and I have a history of kidneystones.

I have to keep a headache log for a couple of months to get a baseline prior to treatment and he wants me to be finished with other treatments before starting this.

I still have a few more weeks of cranial sacral therapy at the osteopathy.

Starr, I am sorry that you are so discourage, I know how frustrating it is to keep looking for answers and not finding them.

Frankly the botox thing kind of scares me. After all botox is a poison.

Best wishes.

Norma
__________________
MVA March 2012 pcs, post traumatic vision syndrome, convergence insufficiencies, vision mid line shift syndrome, gaze stabilization and vision tracking. Fatigue, headaches and sore eyes are main issues.

Current activities: chiro, massage, prism glasses, vision therapy, yoga, meditation, aquafit classes and rest.....
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Old 02-06-2014, 01:42 PM #9
Mokey Mokey is offline
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Hi Starr,

I had a lidocaine injection to block nerve pain after the new neuro-opthamolosit told me I had occipital neuraligia. I was in the middle of a five day massive headache and it went away almost right away. Stayed away for a few days! He said that if that worked, he can add a little steroid to the lidocaine and some people get a lot of relief (weeks!) from that. I may try the next time my headache makes me want to die!!! here is a website that mentions it in a middle paragraph:
http://www.headache-treatment-option...neuralgia.html
__________________


What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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