Headaches: signs you might need an MRI

If you are currently suffering from headaches or migraines, you are not alone! Headaches are one of the most common neurological complaints, and most people will do whatever they can to find some relief.

If you are worried about the symptoms or frequency of your headaches, speaking to your doctor is good first step.

Your doctor may perform a physical exam, refer you to a specialist or may request diagnostic tests, such as an MRI scan, to investigate your symptoms and check for any underlying medical conditions.

Why have a brain MRI scan?

Magnetic resonance imaging (MRI) scan is a non-invasive medical test that uses a magnetic field and radio waves to create detailed images within the body, to form a detailed 3D image of the area.

The detailed images can help doctors identify abnormal growths, or other structural issues, which means that MRI scans are commonly used to diagnose a variety of medical conditions, including those that may be causing headaches.

Additionally, MRI is a non-invasive procedure that does not involve radiation exposure, unlike other imaging tests such as CT scans. This makes it a safe and effective diagnostic tool for evaluating headaches, especially in patients who may need multiple imaging studies over time.

What can an MRI scan of the brain show?

MRI scan brain images can be used to diagnose and monitor a wide range of neurological conditions, including:

  • Tumours and other abnormal growths in the brain or surrounding structures
  • Trauma to the brain, such as from a head injury
  • Blood vessel abnormalities, such as aneurysms or stenosis
  • Brain diseases, such as multiple sclerosis or Alzheimer's disease
  • Inflammatory conditions, such as meningitis or encephalitis
  • Infections, such as abscesses
  • Epilepsy and other seizure disorders
  • Degenerative conditions, such as Parkinson's disease or Huntington's disease
  • Developmental disorders, such as hydrocephalus or cerebral palsy

Why would a neurologist or doctor request an MRI for headaches?

If your doctor has advised that you need a brain MRI scan, this may seem a little daunting. MRI scans are often requested to investigate symptoms, check for underlying causes, or to rule out more concerning medical issues.

There are several reasons that may prompt your doctor to request an MRI scan, including:

  • If your headaches are daily or very frequent
  • If your headaches are getting worse over time
  • If your headaches occur after being physically active
  • If your headaches have changed or your doctor has some further concerns
  • If your doctor is concerned there is a structural issue causing your headaches
  • If you have any additional symptoms, such as fever, confusion, weakness, numbness, or difficulty speaking.
  • If your headache suddenly develops and it feels like more painful than any other headache, or like something has burst in your head.
  • If you have a history of cancer, HIV or other serious medical conditions
  • If you have had inconclusive test results from other diagnostic tests, such as a CT scan.

Not all headaches or symptoms require an MRI scan, but please seek medical advice if you are experiencing any of these symptoms.

Can MRI help diagnose the cause of headaches?

A brain MRI can help find any structural issues or medical conditions that may be causing your headaches, and help your diagnose conditions such as:

  • Brain tumours or other structural abnormalities in the brain.
  • Aneurysms or other vascular malformations.
  • Migraines.
  • Trigeminal neuralgia.
  • Multiple sclerosis.
  • Sinus infections or sinusitis.
  • Temporomandibular joint (TMJ) disorders.

What are the different types of headaches?

It can be helpful to know more about different types of headaches, so you can be aware of any changes in your headaches or additional worrying symptoms.

These are a few examples of common headaches, their causes and symptoms:

Tension headaches are the most common type of headache and symptoms include a dull, aching pain that feels like a band around the head.

They can be caused by stress, anxiety, or tension in the muscles of the head and neck.

Cluster headaches are a type of headache that occur in cycles, often lasting several weeks or months at a time.

They are characterised by severe, stabbing pain on one side of the head, as well as tearing, redness, and congestion on the same side of the face.

Migraines are a type of headache that is typically characterised by intense pain on one side of the head, as well as nausea, vomiting, and sensitivity to light and sound.

Many migraine sufferers find their migraines begin after an aura, which can include visual disturbances, such as flashing lights or zigzag lines.

Sinus headaches are caused by inflammation or congestion in the sinuses, often as a result of a cold or allergies.

They are typically characterised by pain and pressure in the forehead, cheeks, and nose.

Hormone headaches are often associated with changes in hormone levels, such as those that occur during menstruation, pregnancy, or menopause.

They can be characterised by a dull, throbbing pain and can be accompanied by other symptoms such as nausea and sensitivity to light and sound.

Medication-overuse headaches are caused by overuse of pain medications, such as aspirin or ibuprofen, as the body becomes dependent on them.

They are often characterised by a dull, constant headache that worsens with the use of pain medications.

Exertion headaches are caused by physical activity, such as running or weightlifting.

They are often characterised by a throbbing pain on both sides of the head and can be accompanied by other symptoms such as nausea and vomiting.

Thunderclap headaches are a type of headache that comes on suddenly and is often described as the worst headache of a person's life.

They can be a sign of a serious condition, such as a brain haemorrhage or stroke.

If you are experiencing persistent or severe headaches, it's important to consult with your healthcare provider to determine the underlying cause and appropriate treatment.

Could headaches be a sign of something more serious?

Most headaches are not a cause for concern and can be managed comfortably at home

However, it's important to be aware of warning signs that may indicate a more serious condition, such as:

  • A sudden, severe headache, which could be a sign of a ruptured aneurysm or haemorrhage in the brain.
  • A headache accompanied by fever, neck stiffness, or confusion, which could be a sign of meningitis.
  • A headache that is getting progressively worse, especially in older adults, which could be a sign of a brain tumour.
  • A headache accompanied by vision changes, weakness, numbness, or difficulty speaking, which could be a sign of a stroke.
  • A headache accompanied by seizures, loss of consciousness, or vomiting, which could be a sign of a serious neurological condition.

It is important to get immediate medical attention if you, or someone you know is experiencing any of these symptoms.

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