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Dr. Spaho, Happy New Year! I Was Asking You Before

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Posted on Fri, 31 Jan 2020
Question: Dr. Spaho,
Happy New Year! I was asking you before about my daughter about her constant headache for 2.5 months. Her MRI result came back normal. We are still waiting for the neurologist appointment. Her headache is slightly better and she can now handles her homework and returns to her ballet class but it's still there. She did MRI and the result is unremarkable.
Recently when consulting around, we got advice to do brain blood flow testing in addition to brain MRI, also to scan her neck. However, her MRI report seems to have already covered this. So i wonder if you could clarify whether there is such a thing called brain blood flow analysis (which can identify abnormal developmental issue of blood vessels or blood clog. And wonder you think her MRI report is already thorough. Thanks a lot!
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Follow up: Dr. Dr. Erion Spaho (2 minutes later)
I just uploaded her MRI report Findings section. Hope you can advice whether this already covers brain blood flow testing and neck related testing. I looked at the words and it seems it did comment on hemorrhage and intracranial vessels. Also it mentioned craniocervical junction...
thanks a lot!
doctor
Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
No need for DSA. Read below.

Detailed Answer:
Hello and thanks for asking me directly.

I have read your query and the MRI report.

There is actually a study modality that evaluates brain blood flow ( DSA or digital subtraction angiography ).

It is an invasive procedure done under anesthesia, but is indicated in cases that there is evidence of brain hemorrhage, ischemia, vascular malformations, etc. from other studies such as CT scan, MRI/MRA.

In your daughter's case there is no evidence from brain MRI (unremarkable MRI) that may require further investigation with DSA.

Frontal venous developmental anomaly seems to be a normal variation of anatomy.

The craniocervical junction is the part that the skull is linked with the spine, so, the entire cervical spine wasn't examined by the MRI, only the upper part.

In conclusion, I don't think DSA is necessary in your daughter's case, the neck may be studied further with imaging if the Neurologist will think so.

Happy New Year to you too.

Hope this helps.

Take care.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Erion Spaho (5 hours later)
Thank you so much Dr. Spaho! all clear!
doctor
Answered by Dr. Dr. Erion Spaho (2 hours later)
Brief Answer:
You are welcome.

Detailed Answer:
Glad I helped you.

Feel free to ask me if you have further questions.

Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4499 Questions

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Dr. Spaho, Happy New Year! I Was Asking You Before

I just uploaded her MRI report Findings section. Hope you can advice whether this already covers brain blood flow testing and neck related testing. I looked at the words and it seems it did comment on hemorrhage and intracranial vessels. Also it mentioned craniocervical junction... thanks a lot!