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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> MRI or CAT or what?
        
(Message started by: Ob1kanobee on Feb 8^th, 2008, 12:06am)

Title: MRI or CAT or what?
Post by Ob1kanobee on Feb 8^th, 2008, 12:06am

When you make an appointment with a headache specialist, I was wondering if they are going to have you have either an MRI or CAT done? Just wondering what has been peoples experience here....

If so, do you have to get a dye injection as well?

I'm an episodic and my cycle last about 6 to 8 weeks. I'm getting hit about once a day at 1:00 in the afternoon although I did get one at 6:00 AM this morning. Thank goodness for the 02 and energy drinks.

Also, has anyone here ever had a Prednisone taper knock out a short episodic cycle like mine or think it could be possible?

I would like to give my General Practioner information on Prednisone and CH. If there is a link for that, could you please post.

Title: Re: MRI or CAT or what?
Post by Melissa on Feb 8^th, 2008, 3:02am

Mine was an MRI, no dye. Also, I'm episodic (40 day cycles) and have done the pred. taper that'd give me a few PF days but never ended a cycle for me.

Title: Re: MRI or CAT or what?
Post by barry_sword on Feb 8^th, 2008, 6:52am

Hi, I had a Catscan with dye and my head got an all clear. I have done a couple Predisone tapers and they helped control the hits until the Verapamil kicked in. Talk to your Doc about what options are good for you.

Good to hear you have o2, that is my main weapon for the beast.

Barry

Title: Re: MRI or CAT or what?
Post by DennisM1045 on Feb 8^th, 2008, 7:37am

A head scan to rule out other more sinister problems is a good idea. Headaches can be secondary to tumors or other issues in the brain. While CH really sucks, brain tumors can kill you. If you have one you want to know.

Good luck...

-Dennis-

Title: Re: MRI or CAT or what?
Post by Bob_Johnson on Feb 8^th, 2008, 8:25am

Pred very effective to quickly abort a cycle. See,
http://www.plainboard.com/ch/chtherapy.pdf

Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S. (2002)
-----------------------

(The answer is not yet clear........)

"To scan or not to scan in headache
Some patients with primary headaches may need imaging"

"Some life threatening brain disorders present with secondary headache, where the headache is caused by the disease. A brain tumour, for example, is best diagnosed by brain imaging early in the course of the disease, which is essential for optimal management of this and other secondary headache disorders. However, brain tumours, as an example, account for less than 0.1% of the lifetime prevalence of headache.1 This contrasts with the fact that most headaches in the community are either associated with mild systemic infection or due to primary headache,1 where the headache is itself the disorder. Dissecting primary from secondary headache is the problem, since, by definition, primary headache does not need brain imaging because no disease process exists that leads to macroscopic change in general terms.

"How does one dissect primary from secondary headache? This question can have only a clinical response since no controlled trials have been conducted to identify causes of secondary headache. In clinical practice we generally accept that the so called red flags of headache should trigger a search for secondary headache.2 Thus change in the pattern of headache; new onset of headache in people older than 50; onset of seizures or headache associated with systemic illness, including fever; personality change; or with symptoms suggestive of raised intracranial pressure, such as new onset headache in the early morning; or headache that is worsening with coughing, sneezing, or straining should each be viewed with concern. Acute onset of the worst headache of the patient's life should trigger immediate referral for consideration as a sentinel headache of an intracranial aneurysm. An abnormal neurological finding is a clear indication to investigate, unless the finding is longstanding.2 Fortunately most worsening of headache is probably longstanding primary headache going into a more troublesome period, which mercifully is not a marker of a life threatening problem."

Source: BMJ 28 Aug 2004[Not complete article here.]
====================================================================================================
"Imaging Strategies"
"For the vast majority of patients presenting with a headache, no imaging studies are necessary. It is estimated that only 1 in 250,000 headaches are secondary to a life-threatening condition compared with the 1 in 11 Americans who suffer from migraines.[3] The US Headache Consortium has recently offered guidelines for imaging.[4] Patients with an abnormal neurologic examination should be considered for imaging along with those presenting with an atypical headache. Magnetic resonance imaging (MRI) and computed tomography (CT) are the usual accepted methods of imaging. The Consortium has no evidence-based recommendation regarding the "relative sensitivity of MRI as compared with CT in the evaluation of migraine or other nonacute headache."[4] However, MRI is often preferred to look for suspected underlying structural abnormalities, such as tumors, while CT tends to be preferred for diagnosing subarachnoid hemorrhage.

"Dr. Unger discussed headaches at the 2003 AAFP Scientific assembly and presented the following "comfort" and "danger" signs as guides for imaging or other additional testing.[5] Comfort signs that are less likely to be associated with a secondary or life-threatening headache include positive family history of migraine, headaches that are menstrually related, those preceded by typical aura, or those that are periodic and stable over time. The clinician should consider additional testing in the presence of any "headache danger signs:" "the worst headache of my life"; sudden onset of a severe "thunderclap" headache; new onset in a patient older than 50 years of age; fever, confusion, or neck stiffness; loss of consciousness or any focal neurologic finding; or any change in headache pattern, such as progressive headaches without any symptom-free intervals. Dr. Darlow also added that the need for reassurance, either for the patient or clinician, is a possible reason to screen."[6]

Source: MEDSCAPE
==================

Title: Re: MRI or CAT or what?
Post by tommyD on Feb 9^th, 2008, 4:08pm

The neuro who diagnosed me did, and had me do, a number of little exercises as what he said was "a general check of your neurological health." This was back in '01, and I wish I could remember more details, but I recall I was kind of amused by the things he did - pinching my fingers and tapping my knees and looking at my eyes and such...

I figure these could have been little tests he did to decide whether I needed an MRI or CAT, so funny or not, I apppreciate he would do this rather than just routinely send me on an expensive visit to some million-dollar machine.

'Cos I'm cheap.

-tommyD

Title: Re: MRI or CAT or what?
Post by Stinger on Feb 10^th, 2008, 1:32pm

I just saw my neuro last week and he ordered another MRI because it has been three years since I last saw him. The MRI, in my case, usually shows I have no problems. I have been on pred since last week and have not not had a headache. We'll see when I'm off the pred in a couple of days.