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23 year old had stroke. Feeling weakness and pain in hands and neck. Should go for neck spine MRI?

Answered by
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Dr. Neelam Ashish Vanjari

General & Family Physician

Practicing since :2007

Answered : 351 Questions

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Posted on Wed, 22 Aug 2012 in Stroke
Question: I wrote yesterday about this query.

The trouble I am having is with presenting myself to my doctor.

I was in the out of hours clinic today and she said that I had weakness in my left hand, I couldn't move my head back and forward and also tension down to my shoulders. She believes the problem lies with my neck as a long term problem, rather the neurologist I saw who is investigating short term stroke symptoms.

The out of hours service say I need a neck MRI and head MRI while I am there. She felt that my presentation was consistent with some kind of neck compression problem and that I need to see my doctor today to include the neck in the MRI.

I go to my doctor, he doesn't examine me at all. Gives me some pain killers and says the problem is with your head symptoms. He said I didn't present with neck problems when I presented with my hand problems, but the thing is I have neck tension all the time, so it has to be extremely bad for me to think of going to the doctor. Usually they give me neck stretches to do.

He also didn't examine my hand which has some weakness and lack of movement. When I was in A&E with stroke symptoms they said if I get hand weakness to return to A&E.

This was my original question yesterday -

I saw a Neurologist last week who recommended a Head MRI

Since then I have had intense pain in my neck and hand problems, like today, my hand was really heavy and I felt like I wanted to shake it or throw it and it felt shaky.

My question I guess is do I need to keep appearing to doctors, or since a test is in place already, shall I just leave it. I don't think the Neurologist had the full picture of my health but then she must have picked up a little.

I am also unsure what constitutes hand weakness, I am having trouble moving my hand - if I spread my hand out the middle finger moves from left to right. Two of my knuckles look bigger than normal and am getting shooting pains at times. Plus trouble moving my fingers as if playing a piano.

A month ago I had stroke like symptoms but am 33.
Asked by Me , 23 hours ago
Doctor's reply to your question above...
Hi,

Thanks for your query.

The pain in the neck, weakness and pain in hands is a typical presentation when there is a compression over the cervical spinal cord.

I recommend a Neck spine MRI more than a Head MRI.This may show any kind of deformities in the cervical (neck) spine which may be compressing the part of spinal cord which supplies the upper limbs.

The compression of the nerves supplying the upper limbs arising from the cervical spinal cord does present with weakness, shooting pain, abnormal or loss of sensations and rarely swelling due to autonomic disturbances.

I suggest you to get the scan as soon as possible as this is a progressive condition and may need an emergency intervention to cure it.

Please feel free to ask any doubts if you have.

Regards,
doctor
Answered by Dr. Neelam Ashish Vanjari 6 hours later
Hi,

Thanks for writing in.
I understand the confusion you are facing regarding the symptoms and diagnosis.

Your symptoms are indicative of two differential diagnosis- namely
1] Cervical cord compression.
2] Stroke.

But we have to differentiate them so that we can come to conclusion.

If you had stroke; you would have experienced headache/blurred vision/transient loss of vision along with numbness and weakness of hand.

Did you experience the same?
Along with symptoms if we do Brain - MRI, it helps to confirm the disease. An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages and extent of disease can be made out.

Now we will discuss 'Cervical cord compression'.
Your symptoms are more of this diagnosis. Neck tension is common along with numbness, weakness of hand.
We need to do MRI- neck also to confirm it.

Treatment needs -
1] Anti-inflammatory drugs like ibuprofen, valdecoxib.
2] Regular neck exercises
3]You can apply heating pad for relief of pain.
4] soft collars will also be prescribed.

I would suggest you consult neurologist and get MRI-neck and brain done soon to diagnose condition before it worsens more.
I hope I have answered your query. In case of any doubt, I shall be happy to help you.
Best regards,
Dr. Neelam.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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