MRI Results: When to Seek Further Medical Advice

Magnetic Resonance Imaging Interpretation Issues

Hello, doctor.
I have been experiencing some health issues, so I underwent a health check-up and paid for a full-body MRI.
I would like to ask the following questions:
1.
The MRI report from the health check-up only mentioned a cyst in the nasal area, and everything else was normal.
I would like to know if issues such as cervical disc herniation in the head and neck region would typically be noted by the radiologist.
Or is it possible that they did not mention it because it is not a significant issue? I have been experiencing pain in my neck and shoulders, and my eyes have felt strange lately.
The ophthalmologist did not find any cause, and my blood pressure has been consistently high, which feels unusual.
Could this possibly be caused by sympathetic cervical spondylosis? Should I take the MRI interpretation films to a doctor for evaluation, and if so, which specialty should I consult?
2.
I have been experiencing strange focusing issues with my eyes, dizziness, and persistent high blood pressure (140-150).
I have seen specialists in ophthalmology, neurology, cardiology, and nephrology, but no abnormalities were found.
The overall health check report and MRI did not reveal any related causes, yet my symptoms persist.
Additionally, I have been feeling unable to control my anxiety.
Should I consider the possibility of autonomic nervous system dysfunction and seek treatment from a psychosomatic medicine specialist? Also, I would like to know if symptoms of autonomic nervous system dysfunction will resolve on their own if left untreated.

Mr. Wang, 20~29 year old female. Ask Date: 2023/07/22

Dr. Jiang Junyi reply Neurology

Dear Mr.
Wang,
You mentioned, "it's not a significant issue, so it wasn't documented." This often reflects the personal judgment of the radiologist who interprets the report; some physicians may choose to minimize descriptions to avoid complicating explanations for the clinical doctors.
You noted "persistent hypertension (140-150)," which at your age may warrant consideration of secondary hypertension.
Numerous factors can contribute to elevated blood pressure, such as metabolic syndrome (hypertension, hyperglycemia, hyperlipidemia, obesity), autonomic dysfunction (excessive stress), and medications (such as the antihistamines you are taking, especially if they contain vasoconstrictors).

If your blood pressure is elevated, it is advisable to first improve your diet (consider the "DASH diet") and engage in moderate exercise.
I recommend discussing further evaluations and treatment options with an internist or family medicine physician (at a minimum, testing for metabolic syndrome and other potential causes of hypertension).

Thank you for your inquiry, and feel free to discuss any related questions further! Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2023/07/22

More Info

When interpreting MRI results, especially when they indicate potential issues like a nasal cyst or other abnormalities, it's essential to understand the implications and when to seek further medical advice. Your concerns about neck pain, eye issues, and persistent high blood pressure are valid and warrant a thorough examination.

1. Understanding MRI Reports: MRI reports are generated based on the imaging findings observed by radiologists. If your MRI report only mentioned a nasal cyst and did not indicate any issues with the cervical spine, it could mean that no significant abnormalities were detected. However, it's important to note that not all conditions, such as minor disc herniations or subtle changes, may be reported if they are deemed clinically insignificant. If you are experiencing neck pain and shoulder discomfort, it is advisable to consult with a specialist, such as an orthopedic surgeon or a neurologist, who can evaluate your symptoms in conjunction with the MRI findings. They may recommend further imaging or tests to assess the cervical spine more thoroughly.

2. Symptoms and Specialist Referrals: Your symptoms of dizziness, visual disturbances, and high blood pressure could be interconnected. While you have seen various specialists without finding a definitive cause, it may be beneficial to revisit your primary care physician or a neurologist to discuss the possibility of cervical spine issues affecting your autonomic nervous system. Conditions like cervical spondylosis can indeed lead to symptoms such as dizziness and visual disturbances due to nerve compression or vascular issues.
3. Autonomic Nervous System and Anxiety: The symptoms you describe, including anxiety and difficulty focusing, could be related to autonomic nervous system dysregulation. This condition can manifest in various ways, including increased heart rate, blood pressure fluctuations, and gastrointestinal disturbances. While some individuals may experience spontaneous improvement, it is generally advisable to seek treatment, especially if symptoms are persistent and affecting your quality of life. Treatment options may include cognitive behavioral therapy, lifestyle modifications, and possibly medication to help manage anxiety and stress.

4. Follow-Up and Monitoring: Given your ongoing symptoms and the lack of clear findings from previous evaluations, it is crucial to maintain open communication with your healthcare providers. Bringing the MRI images to your next appointment can provide additional context for your physician, allowing for a more comprehensive assessment. If necessary, they may refer you to a multidisciplinary team, including specialists in neurology, orthopedics, and mental health, to address the various aspects of your health concerns.

In conclusion, while your MRI report may not indicate significant issues, your symptoms suggest that further evaluation is warranted. Seeking a second opinion or additional testing can provide clarity and help guide appropriate treatment. Remember, proactive engagement with your healthcare team is key to managing your health effectively.

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