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What causes vertigo,pain and pressure at the back of the head and neck?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Hello. I would like someone to look at an Mri I had done recently to see if there is a Chiari Malformation. I recently had a CT scan done as a routine checkup as I have follicular nonhodgkins lymphoma and the report mentioned low lying cerebellar tonsils and crowded foramen magnum. I've been having symptoms of vertigo, unsteadiness, pain and pressure at the back of my head and neck, numbness of the hand and feet., weakness of the legs. insomnia and memory/concentration issues for a couple of months so an MRI was ordered. Any input would be greatly appreciated! thank you.
Posted Tue, 18 Mar 2014 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 9 hours later
Brief Answer: MRI shows features of chiari malformation. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms and MRI report. I agree that the MRI shows features of Chiari malformation and all your symptoms can be explained on the basis of MRI findings. You should discuss your symptoms and MRI findings with your neurosurgeon. The neurosurgeon may plan for a surgery- foramen magnum decompression, which is likely to improve your symptoms. I hope it helps. Please get back if you have any follow up queries. Best wishes, Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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Follow-up: What causes vertigo,pain and pressure at the back of the head and neck? 4 hours later
thank you so much for your reply. I was able to obtain a copy of the radiology report and am confused with the way the radiologist interpreted it. I am attaching the report for your review. he claims everything is normal. I don't want to say the radiologist is wrong but if my CT could see low lying cerebellar tonsils and crowded foramen magnum, you would think this would show somewhat on the MRI, as you had previously mentioned. I have not yet talked to my neurologist about it yet, as my appointment isn't until the 19th. Can you give me an approximation of how low lying you think the cerebellar tonsils might be? thank you again for your input. I just want to make sure I go in the right direction for my care.
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer: It is marginally low. Detailed Answer: Thank you for getting back. Cerebellar tonsil is marginally low, and at the most, it is grade I Chiari malformation. However, I correlated with your clinical symptoms and gave this finding its due importance. If only the MRI film was sent and if you had no clinical symptoms, I too would have noted the MRI to be normal and would not have given this marginal finding the due importance. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: What causes vertigo,pain and pressure at the back of the head and neck? 11 minutes later
thank you so much. I feel a little better having had you look at the films and the report. You have been very kind answering my questions. I think I am going to send all of my films and paperwork to The Chiari Institute here in NY and take it from there. Thank you! Have a nice weekend.
 
 
Answered by Dr. Sudhir Kumar 11 minutes later
Brief Answer: Thank you. Detailed Answer: Thank you and best wishes, Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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