I had an encephalocele repair at birth 40 years ago. All…

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I had an encephalocele repair at birth 40 years ago. All…

I had an encephalocele repair...

I had an encephalocele repair at birth 40 years ago. All went well. Three years ago I had some issues with headaches and things that pointed to MS. The neurologist wanted to do an MRI. I explained that I knew I had two surgical clips in my head from 37 years before. She said that she would have a radiologist look at a ct scan I had ten years before to determine if I could have the MRI. They cleared me and I had the MRI, no MS. I have had headaches recently and I can't help but worry that shouldn't have had the MRI. First, if the MRI had been in issue with the clips would it have been immediate? Second, how can a radiologist determine it is ok just by looking at a ct or xray, they don't even know what kind they were.

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Customer reply replied 7 years ago

Thank you so much! I have a few more questions. My clips were placed in 1973 so I am very concerned that they were metal.

Since my MRI was three years ago do you feel that I am fine or is there a chance they caused that the MRI could have caused an issue that is slowly causing a problem? Should I be concerned at this point or just let it go? I just worry that the MRI could have moved those clips and I could experience bleeding or something.

Second, a radiologist did examine an xray I had about 14 years before the MRI...I had a sinus issues and had an xray in the late 90's. The hospital had record of the xray and the radiologist looked at it and cleared me for the MRI. I am understanding you correctly that the radiologist could look at the MRI and determine if the clips were metal or not, compatible or non compatible with MRI? I am just really terrified that I should not have had the MRI.

I am hoping my headaches are just migraine/tension headaches. They are one sided and not debilitating, I do have fibromyalgia and hashimotos thyroiditis so sometimes when I get the headacches my leg and arm get tingly. The MRI showed nothing, though.

Customer reply replied 7 years ago

Thank you! I will rate you as excellent, you have really helped me. the headaches are worse now, was not really the issue when I had the MRI. I just get concerned that since I had it three years ago maybe a tumor has developed. I do not have nausea, I can function thru them, and they tend to be on the left side. sometimes I will wake with a quick ice pick headache(just three times in the past few months) and other times it is just a left sided headache with some tingly and my scalp kind of feels numb. My pupils dilate normally and I have no drooping in my face. My ear on that side often seems full and when I have it looked at there is no infection . The headaches happen but then disappear for a few weeks. Fibromyalgia and hashimotos are an issue, and I do have great stress. They have also looked into TMJ. This will be my last question, I promise to rate after this. Thank you sooo much for everything!

Neurologist: Dr Subbanna MD, Neurologist (MD) replied 7 years ago

If the headache is worse now compared to the time of mri and it is about 3 years since the mri then it is a good idea to repeat a brain scan now. Although you may repeat an mri but since there is the concern of clips so instead of mri you may go for a ct scan and ct scan is sufficient to look for tumors. MRI is needed if MS is suspected but for conditions like tumors a ct scan is sufficient. But the tumor possibility is extremely less likely in you since there is no nausea and also it sounds like you have not developed any neurological manifestations like seizures, paralysis of limbs or facial droop etc. However you may get a ct scan and a normal ct scan will reassure you that there is nothing serious going on. The ct scan can also show if there was any old bleeding (the one you have been suspecting secondary to the possible movement of the clips, but as I have discussed earlier complication from the clips is extremely unlikely in you,but showing a normal ct scan now can make you very reassured that you have no tumors, no bleeding etc).
Your headache seems mostly tension type based on the information you provided. There may be some migraine component too but since there is no nausea so it is in doubt, most migraineurs have some nausea or vomiting. But tension headache is most likely the possibility especially since you are under lots of stress. Fibromyalgia and the thyroid problems too can contribute to the headache. You are suffering from ice pick type headaches too. The treatment options for the types of headaches you are having include meds like Amitriptyline, or Alprazolam, or Buspirone etc, and stress diluters like counselling (therapy), yogas/meditation, hypnotherapy, biofeedback etc too can be considered. If you have not already tried any of the above treatment options you may try them to help with both the headache and the stress.
Once again in my very strong opinion you are unlikely having any serious problems including any bleeding/clip complications, tumors etc, you may however undergo a ct scan but based on all the information provided by you serious possibilities seem unlikely. All the very best!
You are very welcome and please let me know if you have any further questions. And if you feel you have received the answer to your question please rate me Excellent to compensate me for the time and effort put by me in answering your question.

Dr Subbanna MD, Neurologist (MD)

Category: Neurology

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Experience: American Board Certified Neurologist, Internal Medicine

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 7 years ago · Answer 1

Hi, I am Neuro Doctor, an American Board Certified Neurologist with vast clinical experience.
I have answered both of your concerns below here;
1) First, if the MRI had been in issue with the clips would it have been immediate?
Yes, the effect should be immediate because the magnetic field will displace the clips while you are on the mri table and during the procedure itself. If such displacement of the clip occurred then it will happen as soon as you got exposed to the magnetic field during the mri procedure, if no displacement occurred during the procedure then there should not be any effect on these clips.
2) Second, how can a radiologist determine it is ok just by looking at a ct or xray, they don't even know what kind they were.
There are two points I would like to make here; first of all if you had the clips placed few decades ago and if they were metallic then it is unlikely they were mri safe because the clips that are mri safe are available only recently so if you had the metallic clips placed few decades ago then mri could have an effect on this clips during the procedure. It is not must that all old metallic clips get displaced during the mri but that possibility exits. The second point is; yes you are totally correct the x ray or ct scan is not expected to help to find out the exact model or kind of the clips that were used so from that perspective the x ray or ct scan will not help, however if they had a doubt whether the clips were of metallic or non-metallic then the x ray or ct scan helps because these films can differentiate metallic from non-metallic devices. So if they were just trying to find out whether you had metallic versus non-metallic clips then these films will help otherwise they will not help.
Please let me know if you have any further questions. And if you feel you have received the answer to your question please rate me Excellent to compensate me for the time and effort put by me in answering your question.
Best regards,
Neuro Doctor

Neurologist: Dr Subbanna MD, Neurologist (MD) replied 7 years ago · Answer 2

The clips could be indeed metallic but what ever effect occurs from the mri is immediate and after that there should not be any further complications. And also see that even if they were metallic many times mri may not have any effect on them because if the clips are already fixed in a position and cannot be moved further then the mri may not be able to displace them. And if the clips did move then the bleeding or any other complication due to the result of such displacement of the clips should manifest immediately or say within few minutes after the displacement occurred and there is no explanation why the complications will occur as delayed in nature.
So since the mri was done few years ago there should not be any concern for any progressive or slowly developing problems because the complications from the displacement of the clips should be immediate.
And if the radiologist had examined an x ray of you and cleared for the mri then it is highly likely that these clips were not metallic otherwise the radiologist would not have missed it on the xray.
So looking from any angle there is really no reason to be concerned about the mri effects on the clips because if complications were to occur they were expected to occur immediately, and also there is a possibility you did not have anything metallic placed so the mri moving the clips may not even arise in this scenario.
Coming to the diagnosis of the headache; if there is any tumor etc causing the headache then the mri should have showed it. People with fibromyalgia too can experience various kinds of headache including migraine type, tension type etc and especially with mri coming normal so any serious possibilities are unlikely to explain the headache so this is most likely migraine type or tension type headache. Now for the concern of any bleeding that may have happened during the mri due to moving of the clips - the same mri should have showed if there was bleeding because the displacement of the clips should have occurred the moment they started doing the mri so the films should have showed if there was any bleeding due to the clips. So looking from any angle the possibilities of any serious conditions causing the headache is extremely unlikely including any tumors, bleeding from the clip movement or from any other reasons.
Once again I reassure you that the mri causing the movement of the clips does not look like the cause for your symptoms including the headache for the various reasons discussed above.
You are very welcome and please let me know if you have any further questions. And if you feel you have received the answer to your question please rate me Excellent to compensate me for the time and effort put by me in answering your question.

I had an encephalocele repair at birth 40 years ago. All…

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