UKC

I've been having constant headaches for a number of years and am quite worried. I had a CT scan which didn't reveal anything but am wondering whether it's worth having an MRI for peace of mind, to rule out things like brain tumours. Also is it even likely to be a brain tumour, as I have had the constant headache for 12 years..? If it was a brain tumour then I'd probably be dead a long time ago as I have had it for 12 years...? I don't mind paying, just for peace of mind, just hope I can get a referral from my GP, thanks

In reply to jamesgreenfield:

Do you have any reason to think an MR will reveal something your CT did not? They're very different things with different capabilities. Your GP will be the one who can advise on the potential value of an MR. They will also tell you more about brain tumours and other possible causes of your headaches than UKC.

So... Go to your GP (but please don't just go in demanding a private MR referral without discussing your options with them!)

In reply to minimike:
I'm a reasonable, intelligent guy, there's no way I'd march into my gp's office and demand an MRI, without explaining symptoms etc. I've known my gp for 10 years, we always speak about any problems thoroughly. The situation is that my gp doesn't want to refer me but I think that it might be possible if I go private, I've had this headache literally constantly for 12 years and just need to be 100% certain there are no serious underlying causes. Please don't think I'm just blithely ignoring the medical profession.

In reply to jamesgreenfield:
Do you drink coffee/tea/Coke? If so time to give it up perhaps? People not getting on with caffeine are a common cause of such things.

I'd have thought it unlikely you'd have a brain tumour for 12 years without symptoms getting worse, TBH. But I'm not a doctor.

Neil

In reply to jamesgreenfield:

Sure, no offence meant, I was trying to help..However, many people would do just that and your comments about tumours suggested that you might not have discussed this in detail with a GP.. Also, an MR will not give you 100% certainty either.

Why doesn't the GP want to refer you? Is there a good reason to think that something would be visible on an MR but not a CT? In that case I would have thought you had a good case for an NHS MR. If not, then what's the point in paying for one? MR is not necessarily 'better' than CT.. (I'm not a doctor either)

In reply to jamesgreenfield:

The main reason for going private is speed ie. you can often get scans within days rather than weeks or months (though the NHS can surprise you at times). However, this seems a bit odd as it's more to do with the old "is it worth it debate". A year or two back, my GP basically refused to give me anti-biotics after a tick bite and a length bout of virus type illness as I'd not had some of the other symptoms, on the basis it didn't seem likely and therefore a waste of resources. When I had a seriousness illness before Xmas one of the first things they asked was whether I'd been bitten by a tick. Now, it seems it wasn't that but my point is that I think GP's do sometimes make odd/wrong decisions about what is justifiable on cost/resource grounds. So, if this will help you if only to put your mind at rest, maybe it is worth it. Nowadays I'd not have thought the cost of an MRI was quite so prohibitive as I recall it being 10+ years ago.

In reply to jamesgreenfield:

There is a recent NICE guideline on headaches. Have a read and make an informed decision

In reply to jamesgreenfield:

Do you need your GP to refer you?

When I was in a local private hospital a couple of years ago they were advertising MRIs quite heavily, about £600 IIRC and that was for allsorts of sports injuries, arthritis etc. They didn't need a GP's referal.

In reply to jamesgreenfield:

Surely what you want is a second opinion, not an MRI?

In reply to jamesgreenfield:

Maybe a referral to a neurologist might help, then discuss it fully with the brain specialist.

In reply to jamesgreenfield:

How lo g will it take for the NHS referral and how much will the private scan be.
Add in how much is your peace of mind worth and you have your answer.

In reply to RockAngel:

+1.

This is the way to go. Otherwise why not get a PET scan as well? Sarcasm mode off. The MRI may well show nothing either but that will not help with the headaches. Get a neurology opionion, you can go private for that if you want to. Anyway, you have a headache for 12 years, what's changed?

D

In reply to minimike:
Thanks and sorry for the tone of my reply, yes you might be right, but I just want to rule everything out.

Well I went to a neurologist who said that as the headaches had been going on so long (12 years), that it wouldn't be worth having an MRI scan. However I am still keen to rule out anything serious despite this, for my own peace of mind, as daft as that sounds. However I wouldn't be able to get referred because of what the neurologist said, so I guess like someone else suggested my only option is to go private without referral, which is possible in some places. Then I'd have to weigh up the cost. There is a place near me but that needs referral, but maybe that would be possible as ultimately I would be paying, so it's not a waste of NHS money.

Anyway, I went to a physiotherapist today and on the positive side he said my muscles weren't as tight which makes sense as my headaches have improved recently. I think this is mainly down to no longer wearing a dental mouth guard. I thought it would help headaches but I think it made things worse. I feel more relaxed since not wearing it.

Sorry for the long post, thanks everyone.

In reply to jamesgreenfield:

this isn't about the headaches or something serious, its about your peace of mind, ie a mental state.

if the ONLY way you can resolve that mental state is to have a private scan then do so, the money is being spent on psychology not physiology (cf placebo). Mind you, if post scan you decide that you need a something else to reassure you well.......

do I think it worth it - if you are a happier bunny afterwards yes.
Would I do it for me - no (but the i've had my bonce MRI'd)

sure that doesn't help at all !

In reply to Dax H:

A GP might think it is a waste of time and not refer, with a referral it will depend on the local set up. I've had an MRI within a week on the NHS.

Personally I would be pushing for a referral to a Neurologist.

In reply to jamesgreenfield:


My headaches of 3-4 years was down to a side effect of my meds causing muscle pains in my back and neck which then moved the pain to my head. All muscular and not sinister.

Saying that, my neck is screwed.

In reply to jamesgreenfield:


If you want to rule 'everything' out, then you will need to add a psychiatrist/counselor to your to do list, since headaches are a common psychosomatic condition.

In reply to The New NickB:



He's been to a neurologist already.

I was sent for an MRI once, supposedly to check for head tumours, they kept forgetting about me til it took a year, GP said sardonically, oh well at least you know it isn't a tumour.

Similar here, in that a long term problem isn't going to suddenly manifest itself.

In reply to jamesgreenfield:
There is essentially a long list of reasons why docs would MRI someone's head, based on symptoms people report, and signs, which are thigs doctors and all clinicians detect. E.g. a heart murmur is a sign -the patient won't say they report it; a sore head is not what a clinician finds, but whatpatients report. But private or NHS, if you don't meet the criteria for a MRI, you won't get one. It would be a wrong situation of someone could ask for and get MRI if it isn't needed! Peace of mind is not in itself a reason to do MRI. And in general terms, brain tumours present with other symptoms and signs, neurological or cognitive or behavioural changes, rather than persistent headache over many years. More likely are dehydration, too much caffeine, stress, eye problems etc.

In reply to jamesgreenfield:

Have you had eyes checked? Lots of ways to get crippling headaches to do with your eyes.

In reply to jamesgreenfield:

Can I ask, are you married? Seems to be the cause of my long term headache...

In reply to jamesgreenfield:

Another thing to consider is whether the MRI will actually allow you to stop worrying. In a situation like this, i.e. no clinical suspicion of anything specific and MRI done 'for peace of mind', there are some 'risks' associated with having the MRI done. Namely, what if it shows something? I don't mean something clearly pathological (this seems very unlikely given that both your GP and a neurologist don't think an MRI is warranted). But what if it shows, as happens not infrequently when investigations are done, some non-specific 'abnormality', the relevance of which is unclear.

Will you worry less with a radiologist's MRI report that says something like 'the left X area shows an area of increased enhancement about 13 mm across, the nature of which is unclear. No corresponding finding is visible on the CT scan taken X months ago. A malignant process cannot be ruled out'?

In other words, the result might not be a) normal or b) something BAD, but c) something vague that's not normal but not really abnormal either.

We all worry to some extent about something bad going on inside us, but MRIs, just like any medical investigation, do not necessarily reduce the uncertainty and worry. Ambiguous results can result in continuing worry, something that private clinics offering all sorts of investigations don't mention in their ads. If your GP and neurologist say there's no need for it, I would think long and hard before going for an MRI.

In reply to jamesgreenfield: Have you considered a tailor?

There was a man who had had a headache for twenty years and was at the point where he wanted to end his own life, but he decided to go to a specialist first.

No doctor could solve his problem, until finally one of them said "You have a very rare problem, your testicles are pressed up against your spine causing your headache. The only way to remedy it is to remove your testicles."

The man hesitantly agrees and gets them removed.

On his way home he walks past a taylor shop with a sign saying "ALL SUITS HALF PRICE"

Being in need of a new suit he walks in where a man greets him and says "Hello Sir I see you want a suit, I would say that you are a 34 sleeve and a 24 pant."

"Wow! How did you know that?" said the man.

"Why Sir I've been in this business for 40 years. Would you like shoes to go with that?"

"Sure" says the man. "Okay I'd say that you're a size 10 wide."

"Ok, now you're freaking me out...Thats a great talent" says the man.

"Thanks" replied the shopkeeper, "Now how about some undergarments?"

"Ok see if you can guess my size", said the man.

"Easy 36" said the shopkeeper.

"Nope 34" replied the man.

To which the shopkeeper exclaimed "Impossible a size 34 would skwish your testicles against your spine and you'de get a headache".

In reply to jamesgreenfield:


Have you tried pysio/massage? A couple of my colleagues who get migraines find they are associated with neck/back tension/stiffness and that loosening the muscles helps.

In reply to jamesgreenfield:

I would eliminate diet factors first, - my wife had headaches as long as I have known her (no sarky comments please), often involving hospital admission, she could be crawling up the walls in pain. She too was convinced she had a tumour.

Eventually she was persuaded to try eliminating certain foods.
After eliminating caffeine and chocolate, she has not had a headache in two years (so it wasn't me), except for when she has partaken in either of those substances.

In cafes, she insists on decaffeinated coffee, but even when they say OK, we know when they gave her caffiene. You may need to give it a couple weeks to start working.

We have suggested this to two other sufferers, with the same success.

In reply to Sir Chasm:

Like it

In reply to Trangia:
i second exploring dietary factors esp choc, caffeine, cheese. id really have to need it to consent to a ct scan, the amount of radiation is a significant risk

i also second an eye test

In reply to jamesgreenfield:

Hi, I have just been for MRI to exclude possibilty of brain tumour and the main symptom that got me referral was bouts of vertigo. Could also and more likely be balance mechanism in the ear. However, vertigo, in my case was the major symtom to trigger an MRI scan. Actually, because I have had bouts of vertigo for some years, I'd probably be dead by now { said ENT specialist- no commendation for my GP!} so longevity of symptom seems to be positive point and points to ears. Don't know if headaches alone are a symptom.....Lots of causes of headaches including eyesight problems. Anyway that's my experience and don't know if it helps. P.S, I'm not dead as yet despite the length of time to get the result back from hospital!

In reply to MargieB:

My Dad has that and it's Menieres, a far more common cause than a tumour.

Neil

In reply to jamesgreenfield:

Ct rules out brain tumours definitely . Also brain tumours that cause headache are large meaning 1. They will show up on ct. 2. A brain tumour that was causing headache would have killed you long ago. Brain tumour is impossible.

Next question. Why do you have headache? Much more tricky , though tension type headache from worrying about brain tumours would be the most obvious diagnosis . Go to www.patient.co.uk look up tension type headache and see your gp again. Alternatively spend the money you were going to waste on MRI seeing a neurologist , who would probably diagnose tension type headache.
Good luck

In reply to jamesgreenfield:

Just watch your insurance, if you think you are under insured, I would look at that now , because once you have had the test ( assuming it found anything ) you would not be then able to increase it.

In reply to jamesgreenfield:

I went for a scan to find a suspected brain tumour and they didn't spot it... I did actually have one that was removed shortly afterwards. Scans aren't perfect and still rely on human operation and diagnosis.

In reply to rurp:


>

CT missed my brain tumour... it was quite small but they were targeting a 10x10mm area, the tumour was there and was half that size. Hard to miss I'd have thought but it was. I had headaches from it as it was in a rather nasty place.
To say a brain tumour causing a headache will have killed him long ago is incorrect. I had my tumour for 7 years or so before it was removed. It wasn't cancerous, it would have kept growing and it wouldn't have killed me for many, many years.

To the OP - no one knows how you feel better than you, I was told I was fine when I blatantly wasn't and was just fortunate that my dentist made an off the cuff remark that lead to diagnosis. Doctors, surgeons etc are brilliant, amazing but you need to start working through different avenues yourself systematically and involve them in that. The onus is on you tho.

Best of luck with it all and I hope you get sorted.

In reply to mrchewy:

What remark did your dentist make ?

In reply to jamesgreenfield:

What sort of headache is it which side of your head, is it constant etc?

Does it make you feel sick or dizzy?

In reply to jamesgreenfield:

It's always great when the non-clinical internet plays remote diagnosis!

But hey, is it my turn?

Diet
Posture
Stress
Ocular
Dental

Purely guessing on the information you've given I'd go for either low grade stress or something postural (perhaps at night).

Get an orthopedic pillow, get regular sleeping hours, lay off caffeine and alcohol for three weeks, stop using screens for a similar period, join a pilates/yoga class, swim 3x/week and run the other days.

Your headache will be gone.







And if it isn't you'll feel loads healthier in lots of other ways...

In reply to Desiderata:

My teeth no longer met, I'd mentioned I couldn't bite my nails anymore - he said that was normal for someone my age who'd given his jaw and teeth quite a bashing at times. I'd played rugby for a while.

Then before I left he said "mind you, if your feet and hands are growing... we need to get you down the hospital". My feet had been growing, over a full size at the time. I love my dentist. I had acromegaly.

In reply to mrchewy:

That' amazing isn't it thank god for your dentist eh! Are you ok now after your surgery?

Have your feet returned to their original size?

In reply to Desiderata:

Feet didn't shrink no but have a pretty rare 'all clear'. Just the usual complications like almost certain to get colon cancer at some point but there's all manner of tests for everything every year and scans every few - it's all good!

In reply to mrchewy:

That's great then just out of interest can you bite your nails again now?

In reply to mrchewy:

Always is a difficult word in medicine, yeah I guess pituitary tumours can be incredibly slow growing and give you headache, and be less than 1cm in size so the ct misses them but usually there are multiple other physical symptoms like the ones you describe in yourself, visual disturbance, blood test abnormalities etc to give you the clues

For James , just check out pituitary adenomas on the web and see if anything tallies then gp to discuss etc etc

In reply to Neil Williams:
Meniers was mentioned by the specialist. However I had an A&E doctor perform the epley manoever[see You tube] before I saw the specialist and that seems to have stopped the episodes and could point to a better and different prognosis. The verdict is out but if that procedure works for me { However it was screamingly uncomfortable to perform it at the time] , then I don't care what it's defined as, so long as I can stop it! I think you told me about your Dad before when I mentioned the problem and attributed it to long haul flights...

In reply to rurp:

Yeah, it's funny, I'd put most of the symptoms down to get older - even my feet getting bigger. I just assumed my arches were dropping. It has taught me to listen to my body.
The top boy consultant in my local hospital was pretty poor mind you, you even phoned up to apologise before packing me off to a specialist centre in Oxford. I guess when it comes to rarer things than the norm, it's hard to be up to speed on everything.

In reply to Desiderata:

Nah - teeth still don't meet. They offered to alter my jaw, move teeth and wire it for a while but my dentist was dead against it. I sorta gotta listen to him!

In reply to mrchewy:


Yep it'd seem like a wise move

In reply to jamesgreenfield: Got result back from MRI scan on NHS and no tumour found. I sympathisize with the anxiety created by even the the thought of a tumour as a reason for peculiar symptoms - once the idea is mentioned it does get to you and gnaw away! Perhaps for this reason alone and to alleviate your anxiety you should get one done or find a way to get NHS to get you one! (Is that unethical?]I now feel a sense of relief at the result....Perhaps your anxiety is reason alone for the NHS to give you one- have you mentioned it to GP?