OpenHealth Q&A

Inquiring About the Need for an MRI Regarding Possible Chiari Malformation

I am a 21-year-old female with asthma and hypothyroidism currently managed with levothyroxine, Wellbutrin, albuterol, and birth control. I’m reaching out for guidance on whether it would be sensible to request an MRI. **Quick summary: After experiencing two simultaneous concussions, I dealt with lingering issues for years. My symptoms have resurfaced strongly, including headaches, tremors, debilitating fatigue, brain fog, eye disturbances, and tingling in my fingers resulting in dropping items.** Four years ago, I sustained a concussion due to a careless incident. Sadly, a month later, while still recovering, I had another impact where I was struck on the nose and my neck jerked considerably. This began a challenging period of relentless headaches that lasted an astonishing two years, during which even prescription medications provided little relief. I also noticed a significant decline in cognitive function; tasks I once excelled at in mathematics became extremely difficult. * While my headaches had moments of respite, going from daily occurrences to several each week, they have recently returned with a vengeance. I now experience headaches 5 to 7 days a week, characterized as a dull ache primarily at the back and crown of my head, fluctuating between 2 out of 10 to an 8 out of 10 in severity. My sensitivity to odors, sounds, and bright lights has drastically increased, and I consistently suffer from neck discomfort akin to having slept awkwardly, accompanied by frequent nausea that makes eating challenging. Applying ice packs for about 40 minutes offers some temporary comfort, yet the relief is fleeting, necessitating my reliance on maximum dosages of Tylenol nearly every day. * Additional symptoms include hand tremors that particularly intensify after any physical exertion. Even a brief stroll causes shaking reminiscent of my uncle's experiences with Parkinson's disease. * An overwhelming fatigue engulfs me, described best as a complete lack of kinetic energy; although my heart beats, I feel utterly immobile. Routine activities, like walking through a mall, often leave me feeling lightheaded. * My memory has significantly deteriorated, resulting in a constant brain fog that makes classroom participation challenging. I often find myself struggling to write notes, as I can read one line then falter at writing even two words before needing to double-check the text again; this level of forgetfulness feels abnormal. * Furthermore, my eyes struggle to focus, particularly on small details or lines. I frequently experience involuntary twitching that disrupts my reading, almost mimicking a reflex called nystagmus, although I suspect it differs (I’ve posted about this previously). * I also often drop items that I am holding, including a hot cup of tea. I experience frequent numbness in my fingers and, at times, in my limbs. **Regarding my headaches:** they are characterized by a combination of pain and intense PRESSURE. At times, I fantasize about a dramatic solution like slicing open my skull to relieve it. Scenes in shows depicting burr holes trigger a visceral need within me, akin to craving food. While I recognize the dangers of self-diagnosing through online sources, Chiari malformation presents itself as the most coherent explanation for my symptoms. The only route to diagnosis is through an MRI. Previously, I underwent an MRI shortly after my second concussion, which indicated no issues; however, I am aware that Chiari can develop gradually following trauma. **Would it be prudent to consider requesting another MRI?** I can no longer access my MRI records, but I do have a brief video displaying some images if anyone is interested.

Answers (1)

7/3/2025, 12:02:09 AM

OpenHealth AI

Based on the detailed symptoms and history you provided, it sounds like you are experiencing significant distress related to your health. Given your concerns about Chiari malformation, it may be wise to consider requesting another MRI. Here’s a structured response to guide your next steps:

Main Points:

1. Consider the possibility of Chiari malformation: Your symptoms and history warrant evaluation for this condition, especially after multiple concussions.
2. Requesting an MRI may be prudent: A follow-up MRI can help assess any changes since your last scan and determine if Chiari malformation or other issues could be contributing to your symptoms.

Explanation:

Chiari malformation occurs when brain tissue extends into the spinal canal, and it can sometimes develop or worsen after head trauma. Your symptoms—including persistent headaches, cognitive difficulties, and hand tremors—can align with this condition, though they may also be related to other issues stemming from your concussions.

Since you previously had an MRI that showed no abnormalities but are now experiencing a resurgence of symptoms, another scan might be useful. Chiari malformation can evolve, and a new MRI could provide clearer insights.

Actionable Next Steps:

1. Document Your Symptoms: Continue to keep a detailed record of your symptoms, including their frequency, duration, and any triggers. This information can support your request for an MRI and help clinicians understand your condition better.

2. Consult with Your Healthcare Provider: Reach out to your primary care physician or a neurologist to discuss your symptoms comprehensively. Clearly express your concerns regarding Chiari malformation and request a new MRI based on your symptom history and current issues.

3. Explore Symptom Management: In the meantime, consider employing management strategies for your headaches, such as:

   • Staying hydrated and maintaining a consistent sleep schedule.
   • Using relaxation techniques or mindfulness to help reduce sensitivity and anxiety.
   • Identifying and avoiding known headache triggers, including certain foods, stress, or prolonged screen time.

4. Stay Informed: Be proactive in discussing your treatment options with your doctor. Share any relevant research you have found about Chiari malformation, and ask about referrals to specialists if needed.

5. Consider Support Networks: Engaging with support groups or communities online may provide emotional support and coping strategies as you navigate your symptoms and seek a diagnosis.

Please remember that while self-advocacy is important, maintaining communication with healthcare professionals is crucial for proper diagnosis and care. You're taking a proactive step in seeking clarity about your health, and that is commendable.