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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Migraine Headaches And Vertigo

Hello, I m 60 years old & have had some cognitive disfunction since an auto accident in 1966, when I had skull fracture, severe TBI. No MRI s had been done since then until recently. MRI report says: History - Migraine Headaches, vertigo, TIA (2009), TBI (1966) Ventricles are normal size & symmetric. 2 areas of volume loss involving superficial gray & white matter. Largest is along inferolateral left temporal lobe = 2.6x1.2 cm on axial T2-weighted image 18. 2cnd area of focal volume loss the gray & white matter along surface of brain is seen within right lateral aspect of hemisphere & this is seen on axial T2-weighted image 36 & off midline sagittal image #s 27 & 28. This area is approx. 2.6x1.0 cm in diameter & involves lateral aspect of right post central gyrus, extending towards the sylvian fissure onvolving a portion of right angular gyrus. There are a few tiny punctate areas of increased T2 signal seen with rt & lft hemispheric white matter- within range of normal for age. Major arterial & dural venous sinus flow voids are present. There is no Chiari malformation.. These findings are chronic & compatible with patient s history of injury in 1966. Please translate? Thank you so much!
Tue, 24 Jan 2023
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General & Family Physician 's  Response
Hi,

ESR, CRP, CGRP is needed. If migraine is diagnosed by a physician then no need. Non-pharmacology treatment is also available like CBT, biofeedback, and relaxation therapy. VNS is also there. From your history, it seems you have taken drugs.

What is most important is if you can learn certain breathing techniques. It prevents more than 70% relapse. Follow up with a neurologist. Yes, there is a greater possibility with injury or it can totally be a new thing! To confirm, there are other dyes and imaging techniques that are not appropriate at your age.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Sunny Madar, General & Family Physician
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Suggest Treatment For Migraine Headaches And Vertigo

Hi, ESR, CRP, CGRP is needed. If migraine is diagnosed by a physician then no need. Non-pharmacology treatment is also available like CBT, biofeedback, and relaxation therapy. VNS is also there. From your history, it seems you have taken drugs. What is most important is if you can learn certain breathing techniques. It prevents more than 70% relapse. Follow up with a neurologist. Yes, there is a greater possibility with injury or it can totally be a new thing! To confirm, there are other dyes and imaging techniques that are not appropriate at your age. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Sunny Madar, General & Family Physician