Can someone have a vascular problem and not see it on MRI

General
1

My 14 year old had a short "wierd" illness for a 2 week period in April (she had a headache, drop attack and inability to swallow). In mid Sept she complained of tenderness above her eye, intense headache and vomiting each morning. She wondered if she hit her head, as it felt like a concusion, but didnt remember hitting her head. Gradually, she added blurred vision, photophobia, and dizziness. On 9/19, MRI was normal. On 10-16, this time she had difficulty walking, dizziness/clumbsiness lasted 2 hours. LP was normal- opening pressure normal, there was blood but not a large amount (350) - thought it was a tramatic tap. 10/25- she was walking and passed out for 12 min. When she woke up she had extreme headache, photophobia. No warning precipitated her fall. EKG normal, CT normal, sent home. 10/28 she was dizzy, could not walk, fell, vomited and was too weak to get up. Extreme headache after event. 10/31 repeat of 10/28, except added numbness to right side arm, and lasted longer (2hrs). Went to Mayo, EKG and ECHO normal, blood work indicates that her CBC count is low (went from 13.8 to 10.8 from 10/25 ER to 11/8). No other tests done. Starting last week-The headaches - as suddenly as they appeared have disappered. Her only complaint- extreme fatigue began around the time we went to Mayo. I can't get her to wake up in the morning. she is sleeping 12+ hours. she has occasional numbness in her arm . Other than that, everything seems back to before.

Mayo asked our local doctor to find out why the RBC dropped, and she is getting her iron levels tested today. At this time- migraines is most likely.

Am I wrong to ask for the MRA? Now that the headaches seem completely gone, I wonder if I am wasting everyones time. It is scheduled for Wednesday. Just wondering if it could be vascular issue - but the early MRI and CT are normal.

Her only + Tests are Visual field loss- mild, Low RBC (recent), blood in LP they felt was most likely tramatic tap.

Family hx: aunt AVM orbit, great grandpa died of abdominial aneurysm, grandpa- sick sinus, sister- Pseudo tumor cerebri, stroke at 17.

2

Hi,

I'm not smart enough to understand the different types of MRI/MRA and CT scans, but I do know that my wife, with the AVM, typically had to have scans "with contrast", where she was injected or drank a dye to make stuff show up better on the scans.

Sorry that's all I know about the subject, but something is going on for sure.

Best wishes,
Ron, KS

3

I found an old thread which you might find interesting…http://www.avmsurvivors.org/forum/topics/mri-mra-vs-angio?commentId=1543517%3AComment%3A386185
Please keep us about your daughter!

4

Im53years old. I had my avm removed through surgery, I had the same problems before rupture. I had a ct scan with contrast which showed build up of blood. Have this and a MRI done. Please keep us informed. I was 22 years old when I had surgery.

5

If the symptoms return, there should be another lumbar puncture. Ask for the MRA. I wonder if the pseudo tumor, for instance, could have been a small avm that went undetected. Small avms are not necessarily detected, especially if a less experienced doctor is reading the scans. Your daughter's cluster of symptoms sound like a subarachnoid hemorrhage is a possibility. Which makes me wonder, with an avm, aneurysm, and a stroke in the family, is it possible that your family has HHT?

6

Hello,

I am sorry to hear about your daughter, I wish you the best. I strongly believe there is no such thing as wasting time. Now to your daughter I was thinking she could be anemic but the blood test on iron and hemoglobin should tell the story on that. My younger brother has been having some of those same symptoms; passing out, numbness in limbs, severe headaches, low blood pressure, vision loss. I would check and make sure contrast is being administer in scans, good idea to have the MRA as well. Best of luck and God Bless.