Patient: I had a head and neck injury on 4/14/15 where a 45lb exercise machine was dropped on the top left side of my head. I have had headaches, dizziness, blurred vision, inability to sleep, memory problems, numbness/tingling of the right arm, numbness in fingers off the right hand, neck pain, and shoulder pain. I have a history of hydrocephalus, ulcers and migraines. I received a cat scan the night of the injury, which came back ok, but they only did my head. I had an mri done and the report states: “no evidence of focal herniation, spinal stenosis, or neural foraminal compromise. There is abnormal cord signal at the level C2, with associated cord volume loss, probably indicative of chronic myelomalacia. There are no prior imaging studies to document stability of this finding. Etiology is uncertain, as there is no evidence of chiari malformation, syrinx, or extrinsic cord compression”. Could this have been caused by my head injury? What are my treatment options? My head mri came back the same as all previous ones.
Doctor: Hi.Thanks for your query, although very complicated as per the elucidate history and the findings of the CT brain an d MRI of the cervical spine. The history of head injury does not fit into the symptoms.In such a case I would recommend you the following:Second opinion of another Neurologist and Neurosurgeon, fresh MRI of the brain and the spine to see if there are any other changes.Start alternative therapy like acupressure or so, we want results too.CSF analysis helps sometimes.Hope this helps.