Archive for ‘Head/Brain’

September 3, 2014

Head Aches and Head Issues #5: What Caused It?

Ice Cream Headache? by Citizen 4474 via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)Now that we’ve covered when not to image the head in case of aches, and what we do to image the head in case of aches… let’s talk about what causes those aches.

 

The biggest fear people have with overwhelming cranial pain is the dreaded T-word. In the vast majority of cases, relax – it’s not a tumor!

 

Instead, the list of causes can be quite long, which means there are many ways of handling pain before jumping into fear-mode. Which of the following common issues can cause headaches?

 

  • migraines
  • tension headaches
  • stress
  • exercise/sex
  • sinusitis
  • dehydration
  • infections – ear or brain (meningitis)
  • dental problems/TMJ issues
  • blood in the brain (from aneurysm or other bleed, or from trauma)
  • post-concussion

 

Answer? All of the above. So before you let your mind wander to a scary place, relax and know that your doctor can help you narrow down the cause of your headache. The treatment may be as simple as hydration by drinking some water, taking allergy medicine to open your sinuses, or perhaps a little deep breathing or meditation to manage stress. You might be surprised to find a little relief is just around the corner from all that racket in your skull. Talk to your healthcare provider about your headache and they can help guide you to potential treatments.

 

To learn more about the long list of potential causes of headaches and what can be done about them, check out great information from the Mayo Clinic, here.

 

 

(Image credit: Ice Cream Headache? by Citizen 4474 via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

August 22, 2014

Head Aches and Head Issues #4: Head MRI – What To Expect

MRI of headIf you are experiencing headaches and your evaluation by your doctor suggests the need for imaging, you may be sent for either an MRI or CT scan. CTs are quick and valuable in the evaluation of patients presenting with headaches after trauma. MRI is an alternative means of imaging the brain and adjacent tissues.

CT vs. MRI

The main differences in the two technologies are as follows. The decision as to which test is needed is based on your history and findings, as well as the following:

 

CT:

  • uses ionizing radiation (avoided in pregnancy unless there are significant findings or significant trauma) in conjunction with computers to generate images
  • takes 10 minutes or less
  • may or may not use IV iodinated contrast material
  • great in looking for blood in and around the brain, which can be traumatic or non-traumatic in origin
  • uses a short bored tube

 

MRI:

  • uses magnets and radiofrequency waves in conjunction with computers to generate images – no radiation
  • can be used in pregnancy after the first trimester and without IV contrast material
  • may or may not use IV gadolinium contrast material
  • takes 30 minutes or more
  • uses a long bore tube (can seem confining although there are ways of treating this sensation!)
  • shows anatomy in greater detail than CT
  • some pathologies such as multiple sclerosis are best visualized on MRI
  • must hold still for longer time periods – may be difficult for younger children

 

 

What To Expect

Before an MRI of the head, no special preparation is necessary. However, metal is a big issue (seriously, the machine is one giant magnet and any metal on your body can become a hazardous missile with potential for harm to you, the technologist or the machine). So – extreme care is used to ensure that you have no metal on your body. Also, metals in things like artificial joints and pacemakers can create problems so full disclosure is needed.

The procedure takes approximately 30 minutes with only the head moving through the machine.

Holding still during the imaging is key to getting good pictures. Images are taken without contrast to begin with and then if needed (and patient is not pregnant) additional series may be run after an IV injection of a contrast material containing the heavy metal gadolinium. This should be used in caution in certain patients with kidney problems, so we always obtain a full history prior to giving this, and may check your kidney function before giving it. The injection may cause a cooling sensation.

What Happens Next

After your exam is completed, the images are studied by your radiologist for interpretation and reporting. The results are then shared with your referring doctor to integrate the new information gained from your head MRI with clinical symptoms for a specific diagnosis. After the test, we recommend drinking extra fluids to help flush the contrast from your system if it was used.

On Your Way!

Headaches can be a vexing issue, and getting you on the road to being headache-free is the goal of the medical team, including the radiologist carefully analyzing those images. As ever, we hope to help to get you on the road to your best possible health.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

August 21, 2014

Head Aches, Head Issues #3: CT Scan of the Head

CT scan by NithinRao via Wikimedia Commons Copyright Public DomainSo if you’ve had a good wallop to the head (or it just feels like you have) your doctor may direct you to a head CT.

 

Like all CTs, a modifiable dose of radiation is used to image the body in “slices” which are then reconstructed into images. Use of radiation in pregnancy should be reserved for special cases, so let the technologists know if you are or could be pregnant.

 

What To Expect

 

Before a CT of the head, no special preparation is necessary. However, metal interferes with the images, so jewelry, hairpins and the like will need to be removed from the region of the head.

 

The procedure takes approximately ten minutes with only the head moving through the machine. Persons with claustrophobia typically do well with CT because the exam is fast and the machine itself is not too confining. Holding still is important – as with all images, motion causes blurring.

 

CT of the head is often performed without contrast. For cases following trauma or in an evaluation for headache a non-contrast examination may be sufficient.  There are times when IV contrast injection is necessary. This additional part of the study can be very helpful to evaluate the blood vessels in the head and for assessment of the brain tissues and its enhancement. The iodinated contrast material will be given thru an IV which may cause a feeling of warmth. Images are then taken in the same manner as the initial non-contrast series.

 

What Happens Next

 

After your exam is completed, the images are studied by your radiologist for interpretation and reporting. The results are then shared with your referring doctor to integrate the new information gained from your head CT with clinical symptoms for a specific diagnosis.

 

On Your Way!

 

That’s it! A CT head is a quick, simple procedure which can be invaluable in looking at your brain and surrounding tissues. It can help get you on your way to being headache- and anxiety – free!

 

 

(Image credit: CT scan by NithinRao via Wikimedia Commons Copyright Public Domain)

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

August 19, 2014

Headaches and Head Issues #2: Looking Inside Your Head

800px-Brain_MRISo… there will be times when a headache prompts further evaluation. Imaging can be used to study the brain and its surrounding tissues. CT and MRI are both common imaging techniques for evaluating the brain and adjacent tissues when imaging for headaches is indicated.

 

For sudden onset headache, thunderclap headache, and headache following trauma in the past 48 hours, we often start with CT of the head.

 

CT Scans

The initial CT imaging is done without contrast; images are obtained through the skull while the patient lies still. This takes only a few minutes.

 

From this we can see hemorrhages in and around the brain – one of the serious causes for headaches that can be seen from both traumatic and non-traumatic causes.

 

Occasionally, the noncontrast study will be followed by postcontrast imaging after an IV injection of iodine-containing contrast – this highlights the vessels and demonstrates abnormal enhancement in the brain, such as masses.

 

CT uses radiation to make its images – therefore, use in pregnant patients will generally be reserved for special indications and circumstances.

 

MRI Scans

If there are any neurologic changes associated with your headaches (things like numbness, loss of strength or confusion) imaging with MRI may be requested. An MRI shows the internal structure of the brain in great detail. Masses and areas of abnormality from things such as strokes and multiple sclerosis are well shown with this modality. Because the procedure takes about 30 minutes to fully image the head, it does require the ability to lay on your back for a length of time. Images can be obtained both without and with IV contrast containing gadolinium, often times with both. Gadolinium contrast helps us look at vascular structure and for abnormal enhancement.

 

MRI can be used in some instances during pregnancy, but only after the first trimester is complete. No IV contrast is used for MRI in pregnancy.

 

Patients with pacemakers and other implanted surgical devices may not be able to undergo MR imaging. Let your doctor know of all surgeries and procedures prior to scheduling your MRI.

 

These exams can shed amazing light on the brain and its functions (or malfunctions). While we always work to image wisely, we can also image exquisitely. From the finest of endings to the largest of masses, we are able to have a noninvasive peak inside the inner workings of the brain. Through this we are able to get our patients on the road to their best possible health!

 

 

(Image credit: Brain fMRI via Wikimedia Commons, Copyright Public Domain)

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

August 13, 2014

Headaches and Head Issues #1: When NOT To Image

headache by Pierre Willemin via Flickr Copyright Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)Headaches are a common complaint and come in different forms. Most headaches, though they may not feel like “nothing” at the time, are often simple and solvable problems.

 

As radiologists we have a special role when it comes to headaches. Ready for this? Most times patients with headaches need not visit their friendly radiologists. The brain (and even the musculature around it) is a complex and honestly beautiful thing. We are advocates of imaging carefully – and there are times when that means no imaging at all.

 

The crux is this: it can be hard to know when a headache should prompt medical evaluation. Rules have been developed helping medical professionals determine when imaging will be most beneficial. if a headache has other symptoms associated with it (such as nausea or vomiting) or is new, significantly worse or comes on suddenly, medical evaluation is warranted and imaging may be needed.

 

According to a recent article published in the Journal of the American College of Radiology:

 

“Most patients presenting with uncomplicated, nontraumatic, primary headache do not require imaging. When history, physical, or neurologic examination elicits “red flags” or critical features of the headache, then further investigation with imaging may be warranted to exclude a secondary cause.”

 

What are the “red flags” that mean imaging may be necessary?

 

 

  • history of head trauma;
  • new, worse, or abrupt onset headache;
  • thunderclap headache;
  • headache with pain radiating to the neck;
  • one sided headache with facial pain;
  • persistent and positional headaches;
  • headache centered at side of head (temple) in older individuals.

 

 

It’s important to not ignore intuition. If something about your headache is unusual, or the circumstances predicating it are new, it is definitely worth seeing your doctor. However, if s/he doesn’t opt for imaging in the initial stages, that may be perfectly okay too. We love seeing our patients on the road to their best possible health!

 

 

(Image credit: headache by Pierre Willemin via Flickr Copyright Creative Commons Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

August 8, 2014

Brain Boost: 10 Mindful Minutes

Andy Puddicombe by DarkerAngels via Wikimedia Commons Copyright Creative Commons Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0)Before we head off (no pun intended) with our series on the brain and imaging above the neck, we thought we’d take a quick 10 minutes to introduce the idea of an important 10 mindful minutes.

 

That meditation is good for you will not surprise you. What may come as a surprise is that it’s not as hard to incorporate meditation into your daily life as one might think. There’s no special set-up required. No incense, no special outfit, no special diet. Just you – that’s all it takes.

 

The brilliant Andy Puddicombe explains it all right here in a charming and insightful TEDtalk:

 

 

 

So give your brain a break, enjoy a healthier life and we’ll be talking more about health from the top of your head on down next week.

 

Have a fabulously restful weekend and don’t forget – Kansas City’s Komen Race for the Cure is Sunday! See you there!

 

 

(Image Credit: Andy Puddicombe by DarkerAngels via Wikimedia Commons Copyright Creative Commons Attribution-ShareAlike 3.0 Unported (CC BY-SA 3.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!