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  • Help needed with C Spine MRI Results

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    Old 06-13-2017, 05:30 PM   #1
    Mav196
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    Help needed with C Spine MRI Results

    Hi
    I need your help to understand my MRI results, in particular "minimal high signal change in the cord" and "impinging on ventral aspect of cord and thecal sac".

    I have been suffering with chronic daily headaches and dizziness for the last 8 months. Initially I was told it was an inner ear (vertigo) problem - on subsequent testing the ENT ruled that out and suspected vestibular migraine and referred me to a neurologist. I attended the neuro 8 wks ago and he diagnosed chronic migraine (I do not have a previous migraine or headache history). I am currently on Gabapentin 300mg in morning and 400mg at night - I am struggling to function during the day - I feel really spaced out and brain foggy on the meds for most of the day.
    I previously had 2 x MRI BRAIN which were clear but neuro wanted mri repeated with contrast and wanted c spine MRI also to rule out CSF leak or any issues with c spine. the results of C Spine are below (MRI Brain was normal) and I would be grateful for your inputs as I have a review appt with neuro on Thursday.
    Thanks for your help.

    MRI CERVICAL SPINE - 2 June 2017
    There is multilevel degenerative disc disease and disc protrusions present at C3-4, C4-5 and C5-6.
    There is minor cord compression at C4-5 by disc material with minimal high signal change in the cord noted at this site.
    Axial imaging confirms the presence of a moderately large central and slightly right sided disc protrusion at C4-5 impinging on the ventral aspect of cord and thecal sac at this site. Smaller disc protrusions are noted at C3-4 and C5-6 levels.
    Following administration of iv gadolinium no abnormal enhancement identified.
    Conclusion: large central and slightly right sided disc protrusion causes early cord compression at C4-5. No evidence of demyelination.

     
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    Old 06-14-2017, 08:13 AM   #2
    teteri66
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    Re: Help needed with C Spine MRI Results

    Welcome to the board. The MRI reveals degenerative disc disease which is a technical word to describe "wear and tear" that occurs to the intervertebral disc or discs causing chronic pain. The discs are the soft, gelatinous cushions between the bones of the spine. They are composed of 90+% moisture. As we age, the discs lose moisture and tend to flatten, bringing the bones close together. Sometimes a bulge forms in the side of the disc and sometimes a hole develops in the outer layer of the disc allowing the disc material to ooze or leak out.

    The report indicates that there are protrusions of the discs at C3-4, C4-5 and C5-6, with the largest one occurring at C4-5. At C4-5 the bulge is sufficiently large that it is pushing out of the disc space and is pushing into the thecal sac (the membrane that surrounds the spinal cord and cauda equina, and contains the spinal fluid.). "Ventral aspect" describes the location where the cord is being indented by the disc material...toward the front.

    Depending on the size of the disc protrusion this may bear watching. Right now it isn't doing any damage to the nerves in the spinal cord, but if it were to enlarge, it could begin to cause some problems, including myelomalacia, which is a softening of the spinal cord.

    "Minimal high signal change" is a technical aspect of the MRI indicating how various tissue densities display on the image. This is a good thing that it is minimal and reinforces the finding that the cord impingement is a small amount and not much to worry about.

    Drowsiness is a very common side effect of gabapentin. It usually resolves as the person adjusts to the drug.

     
    Old 06-14-2017, 12:13 PM   #3
    Mav196
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    Re: Help needed with C Spine MRI Results

    Thanks so much for your response....it has been really helpful and it will guide my questions to the neuro tomorrow
    Kind regards
    Mav

     
    Old 08-13-2017, 12:27 PM   #4
    marymmcc
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    Re: Help needed with C Spine MRI Results

    Gabapentin takes some time to get used to. It is an excellent medication, so try to bear with the brain fog...it will get better. I currently take 1200mg a day in divided doses. A higher dose made me slur my words and unable to function.

     
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