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Old 07-30-2006, 11:03 PM   #1
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Help on MRI, Head Injury and Neck pain

Nearly 3 months ago while flying AA, the plane dropped several thousand feet and my head hit the ceilings resulting in head injury, concussion and other issues. The head CT was normal after few days. The neurologist mentioned that I should get better within a month. I felt like being drunk and had persistant headache for nearly a month. The head started gettting better but the neck started worsening.

After nearly 3 months I had MRI of head and neck as I continue to have headaches, neck stiffness and pressure/heaviness in neck, and upper back pain. The brain MRI was normal, However the following was the result of neck MRI;

Impression:
1. Mild disc desiccation and broad disc bulges betweeen C3 and C6 without resulting in spinal canal stenosis
2. Mild straightening of the usual cervical lordosis. This can be positional or reflect muscle spasm.


Mild straigtening of Usual Cervicla lordosis is present between C2 TO C6.
The cervical spinal canal is widely patent despite mild broad disc bulges at C3-4 and C4-5 and minimally at C5-6. These result in partial effacement of CSF ventral to a normal appearing Cervical cord. There does remain much CSF dorsal to cord and AP caliber of thecal sac exceeds 10 mm at each level. Each disc between C3 and C6 shows mild partial disc deiccation and mild broad disc bulges. The cervical neural Foramina are widely patent without evidence for nerve root compression or neural foraminal narrowing. Anterior veretebral end plate osteophytes are mild between C3 and C6.

I was wondering if someone can provide a simple translation and what does the above mean? How serious is above? I have started Physical Therapy and am on Flexeril, Lodine, Iboprufen 800 mg and so on. However I continue to have pressure/heaviness on my necK. The pain worsens when I move neck and makes cracking sound. I feel better when I am lying down. Thanks for the feedback.

 
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Old 07-31-2006, 07:24 AM   #2
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Re: Help on MRI, Head Injury and Neck pain

Your MRI as I read it is not too bad. Pretty normal actually. The disc bulges are a concern, but they don't seem to be causing nerve compression which is what will cause pain.

The disc deiccation is the normal process of "drying" which occurs as we age.

The only thing I can get out of the report is you may have a muscle spasm that is seen on the MRI.

I would think, you should improve.

Listen to your doctors, and maybe PT would help too.

Dennis

 
Old 07-31-2006, 09:44 AM   #3
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Re: Help on MRI, Head Injury and Neck pain

Thanks Dennis,

How long does muscle spasms last? I have been to several doctors- neurologists and physiatrist. My head has become clearer but I continue to have issues with neck pain and a little of upper shoulder pain (at times, lower left side pain). Not sure what is going on? Does disc desiccation and/or bulging cause this pain?

 
Old 08-01-2006, 07:35 AM   #4
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Re: Help on MRI, Head Injury and Neck pain

The short answer is that as we age, the discs dry out, and eventually can get so small, that the vertabrae start to slide around. This can cause pinched nerves. Your MRI doesn't say that this is the case (I don't know how old you are). The answer for bulging disks is basically the same. They will cause pain if they are pinching a nerve.

Spasms usually are caused by the body reacting to an injury or putting your body in a not normal position to compensate for pain. Bad posture. Also a bad mattress or sleeping position can cause this. The thing you need to do is figure out if any of these things are happening. You can try massage if you can figure out where the spasm is. Also alternating hot and cold (about 15 minutes each) can help.

Physical Therapy (PT), can also help this. You may want to ask your doctor about this.

Muscle relaxers (pills), can help also.

Spasms can last for a long time if you can't get them under control. They go away pretty fast if you get the right treatment.

Dennis

 
Old 08-01-2006, 10:22 AM   #5
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Re: Help on MRI, Head Injury and Neck pain

Thanks Dennis.

I am 42 yrs old and everything was ok prior to the head injury. I struck my head on plane ceiling when the plane suddenly dropped by thousands of feet. I was unconsciouss for a minute or so and developed head bump, redness and scratches. For next several weeks, I had persistant headache, dizziness etc. and was diagnosed with post concussion syndromes. The head has become much better but the neck bothers me now. It is also possible that neck was bad before but since head was controlling, I didnt feel much of neck pain as compared to head. Once headache started diminishing, the neck pain took over. It has been nearly 3 months since the injury incident and I feel pressure and heaviness at the back of my head and neck. The neck pain worsens when I move around the neck. It also seems to cause headaches.

Can the head injury cause disc dessicattion, disc bulging, and straightening of cervical lordosis? Something happend that continues to bother my neck. Wondering what could have happened that is causing neck pain.

I am on Flexeril, Iboprufen 800 mg, Lodine and similar medications. They dont seem to help much. I have had few PT sessions (5-6) that included heat treatment and massage- they seem to help a bit during the session but the neck pain starts the next day.

Any thought and help would be appreciated. Thanks.

 
Old 08-01-2006, 11:51 AM   #6
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Re: Help on MRI, Head Injury and Neck pain

It's possible the injury caused the disc bulging although, this is not uncommon in someone your age, the others are aging and or hereditary. You have to be careful what you read into the MRI report. The explaination you need is to understand the pain. Again, from what I could tell, it is most likely caused by the spasm, and not the other issues. Most MRI's of someone 42 years old will contain most of the stuff yours does, and many are much worse. I would have loved to have your MRI when I was 42. It is possible that something was missed in the MRI, but as it reads, there are no pinched nerves, or other things that stand out besides the spasm. When it says "mild", "cervical neural Foramina are widely patent without evidence for nerve root compression or neural foraminal narrowing." and "Anterior veretebral end plate osteophytes are mild", those are very positive results for those of us that have had to deal with the opposite. Those are the issues that will cause you pain, and you would know it. The pain you describe is not very common with cervical injury. It's not to say that it couldn't be caused by something that isn't showing up on the MRI, but it really looks like the spasm is the cause.

You need to continue therapy on your own if you want to get the spasms to subside. You should do massage and hot and cold on your own. If they showed you excercises in the PT, to loosen and strengthen the neck you should be doing them. If they cause pain while your doing them stop. If they cause pain sometime after, this could be the muscles trying to relax. If the muscles have been tight for a long period, it is normal to feel some pain the next day. Eventually that will go away if you continue to work the area.

Can you feel where the spasm is? Is there a tight area or knot that you can pinpoint? Have you tried to massage it yourself?

 
Old 08-02-2006, 12:10 PM   #7
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Re: Help on MRI, Head Injury and Neck pain

I feel the tightness in neck area just above the shoulders. A tight ring around the neck on the backside seems to have formed. The pain starts from neck and goes upto the top of my head on the backside. There is mild pain in shoulder muscles that started recently and more pain near the lower back on left side when I turn my neck.

I did a few PT sessions- heat treatment, exercise, and massage at the neck. It was soothing at the time but went back to normal pain status the next day. I have been swimming and trying neck exercise to help reduce the pain. Not sure what is going on though.

Can straigthening of lordosis be causing the muscle tightness and pain?

 
Old 08-03-2006, 07:44 AM   #8
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Re: Help on MRI, Head Injury and Neck pain

I'm not sure if lordosis is the correct terminology.

Lordosis is usually used to describe an increased curve of the spine. If I am reading this right they are saying that the normal curve of your spine is mildly straightened. This is not nessesarily caused by an injury to the spine. It is vey possible that this is congenital. As such it probably doesn't have anything to do with your problems.

Given all of your questions, you should consider going back to your doctor and discussing this in detail with him/her.

 
Old 08-10-2006, 05:42 PM   #9
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Re: Help on MRI, Head Injury and Neck pain

How serious is:

1) partial effacement of CSF
2) Mild straightening of cervical lordosis
3) Mild disc desiccation and broad disc bulges


Will any of the above lead to constant pressure/heaviness on neck? I have recently noticed slight tingling and pain in shoulder muscles and on the left side at mid-back. Can this be co-related?

 
Old 08-11-2006, 08:28 AM   #10
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Re: Help on MRI, Head Injury and Neck pain

Given the symptoms, you should go back to your doctor.

Maybe they missed something.

 
Old 08-11-2006, 12:06 PM   #11
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Re: Help on MRI, Head Injury and Neck pain

I recently again visited a neurologist, neurosurgeon, and a physiatrist. I have been asked to start with PT- I have had few sessions (heat treatment, massage, and few exercises). Each doctor gave me different medications- in summary Flexeril, Lodine, Iboprufen 800 mg, Flexeril, Codaine etc.

My head has become much better (previously I had continueos headache), however there continues to be pressure/heaviness on my neck upto top of head. In addition, slight pain has recently started in shoulders and between shoulders and elbow. In particular, I feel more pain in shoulders in the mornings after sleep. Additionaly, severe pain has started in left side of mid-back, particularly while driving car and taking turns. Are these pains all co-related to muscle/spine/nerve or seem to origniate from different parts of the body?

Which part of the spine is most likely to be injured from injury/force/trauma to top part of the head- would it be cervical or thoracic or lumber or all of the above?

 
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