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I received my MRI and MRA of both brain and

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Posted on Fri, 13 Jul 2018
Question: I received my MRI and MRA of both brain and neck results today in the mail. I apparently have a "mild segmental stenosis of the left vertebral artery at the level of C2". Could you help me understand what that means? My symptoms are dizziness when moving my head, neck pain, double vision when straining. Ive had the double vision symptom for about 3 years now and the dizziness for almost a year. I saw a chiropractor last year and the neck pain and diziness went away but came back after 2 months. Double vision started after drinking a lot of coffee for a month and also lifting weights and pushups. Another thing found in the scan was "left maxillary mucosal retention cyst versus polyp identified measuring 1.2 x 0.8cm.
doctor
Answered by Dr. Mahboob Ur Rahman (31 minutes later)
Brief Answer:
means the vessel is slightly narrowed,this may cause the symptoms

Detailed Answer:
Hi, welcome to 'Ask A Doctor service ' my name is Dr Rahman, i have read your question and here is my advice.
The statement means that some part of the vertebral artery ( Vessel which takes blood to posterior part of the brain) is a bit narrowed. This can explain your symptoms, because this vessel takes blood to the posterior part of the brain, and whenever the supply is a bit less then needed ( possibly because of the narrowing), then the the dizziness can occur as the center is there in posterior XXXXXXX of the brain, similarly the part of brain that is involved in seeing is also located in posterior ( back) part of the brain , the blood supply to which is from the vertebral artery. ( This is similar like heart pain occurs when heart vessels are narrowed )
However i would advise you should now follow with an angiography of these vessels that would exactly find our to which extent the artery is narrowed and then if needed to decide about the treatment ( if this is confirmed to be the cause )
Regarding the cyst and polyp , these are not serious, and if you do not have any problem with it, ( like blocked nose,facial pain, face swelling,etc ) , they can be left untouched.


Hopes i have answered your question ; I will be glad to answer any thing else you want to know in this regards. Please feel free to ask anything you need to know .
Good luck

Regards,
Dr Rahman

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Mahboob Ur Rahman (27 minutes later)
Thanks for your reply.

Is this a serious condition? I had a CT Angiogram completed in December 2017 with no visible issues. But there was possible artifact issue with the scan which could have prevented seeing it? I had MRA of head and neck that found this issue but no contrast. How can this be resolved?
doctor
Answered by Dr. Mahboob Ur Rahman (5 hours later)
Brief Answer:
Though not very serious but it is of some.concern .

Detailed Answer:
hi , sorry for being late with the reply ,
infact the seriousness depends on the severity of stenosis , as how much is the stenosis ..as your report says it's mild so it may be little serious but still if it is producing symptoms ( and if the symptoms cannot be explained buy anything else ) then it is of some concern .The only thing that if there is stenosis there is a risk of stroke to happen in future , However this is not very high in little stenosis .
Commonest cause of stenosis is atherosclerosis. I just wanted to know if you have any risk factor for atheroesclerosis ? ( These include hypertensive, diabetes, obesity , dyslipidimia, strong family history of heart probelems)
you are right , that with contrast the sensitivity of of MRA increases to pick it , however MRA is pretty good even without Contrash , so contrast may not be needed .
further management would be decided on basis of your complete history , I think this would be your neuralogist who would be planning ahead .
once this is cofirmed that your symptoms are becosue of it ( it looks to be becosue of it but may have other causes ) and if the cause ios stenosis is atherosclerosis then they may advise you some cholesterol lowering drugs and blood thining drugs that may help alot . Sometimes ( but that's for severe stenosis ) they may arrange some surgory for it but it's not for mild stenosis .Here only controlling the risk factors( mentioned above ) may be all that is needed
I think u can talk to your neuralogist in more details to understand the full scenario.
I would be pleased and would try to explain it as much as possible if you need any thing to ask so please don't hesitate to ask me back .
Best luck .


Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Mahboob Ur Rahman (30 minutes later)
Thanks for the reply. Is it ok to take aspirin to help in the mean time?

The year I started the double vision symptom was the same year I fell and hit the back of my head. April 2015 I fell and hit my head and then October 2015, after drinking a lot of coffee and doing many pushups during that month I got double vision. Then it never went away. Any time I do anything straining I would sometimes get double vision. Then, last year I started to get neck pain and vertigo when moving my head around. Can this be caused by head trauma from several years ago, starting with double vision?

I had my cholesterol levels checked and it was a little high at 131 LDL. I weigh 170 pounds and I am 5ft 10 inches. I am 32 years old and no immediate family history of health issues.

I read some reports from a doctor who treated such cases using warfarin and then aspirin for 4 months. You can see it here: http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2001;volume=49;issue=4;spage=384;epage=90;aulast=Prabhakar

I think there is a role in part of the head trauma and also the high level of caffeine and push ups causing these issues?

Thanks for your time.
doctor
Answered by Dr. Mahboob Ur Rahman (46 minutes later)
Brief Answer:
yes the trauma to neck may have a role,you can take asprin

Detailed Answer:
hi,
You are very right that neck problems can be the cause of this problem and having no obvious risk for atherosclerosis, and a definite history of trauma to neck , the latter may well be the cause as that is second leading cause. Because the artery travel through vertebral formem( holes in side of verterbrea ) and can be compressed there and the staining can be compressing over the artery during your push ups or strains.
Similarly caffeine potentially can cause stenosis(spasm) of arteries but it should not be permanent.
If there is no contraindication for use of asprin ( stomach ulcers, hypersensitivity ) you can use it for sure, however be advised to stick to the advice of your own consultant.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Dr. Mahboob Ur Rahman

General & Family Physician

Practicing since :2012

Answered : 2302 Questions

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I received my MRI and MRA of both brain and

Brief Answer: means the vessel is slightly narrowed,this may cause the symptoms Detailed Answer: Hi, welcome to 'Ask A Doctor service ' my name is Dr Rahman, i have read your question and here is my advice. The statement means that some part of the vertebral artery ( Vessel which takes blood to posterior part of the brain) is a bit narrowed. This can explain your symptoms, because this vessel takes blood to the posterior part of the brain, and whenever the supply is a bit less then needed ( possibly because of the narrowing), then the the dizziness can occur as the center is there in posterior XXXXXXX of the brain, similarly the part of brain that is involved in seeing is also located in posterior ( back) part of the brain , the blood supply to which is from the vertebral artery. ( This is similar like heart pain occurs when heart vessels are narrowed ) However i would advise you should now follow with an angiography of these vessels that would exactly find our to which extent the artery is narrowed and then if needed to decide about the treatment ( if this is confirmed to be the cause ) Regarding the cyst and polyp , these are not serious, and if you do not have any problem with it, ( like blocked nose,facial pain, face swelling,etc ) , they can be left untouched. Hopes i have answered your question ; I will be glad to answer any thing else you want to know in this regards. Please feel free to ask anything you need to know . Good luck Regards, Dr Rahman