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Magnetic resonance imaging (MRI) is a testing procedure used all around the world to capture detailed images of tissues and organs inside the body or head. One of the uniquely-useful attributes of the MRI test is its ability to produce clear pictures of the brain, without using radio-active x-rays. The test is performed using a large magnet, radio waves and a computer to compile and distribute the images.

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MRIs are exceptionally useful for identifying brain and spinal abnormalities, tumors and cysts, injuries to joints, some heart problems, causes of pelvic pain in women and uterine abnormalities. It’s a painless, non-invasive procedure that has revolutionized diagnostic options since its invention.

In many cases, migraine is diagnosed because of the combination of symptoms existing in the patient. On those occasions when the doctor is unable to make a clear diagnosis from history and symptoms, he or she may recommend an MRI. While the test can’t diagnose migraine, it can rule out other conditions that cause similar symptoms.

Here are some of the reasons why, and criteria to help you determine whether a MRI would benefit you in your journey:

Rules out a brain tumor

This is typically one of the biggest fears of anyone suffering from headache pain. Since statistics show 80,000 new brain tumors are expected to be diagnosed this year, it’s a legitimate concern. An MRI distinguishes immediately when a brain tumor is present, and if the patient shows no signs of one then the doctor can look at migraines as a possibility for treatment.

Swollen optic nerve

Called papilledema, this is caused by an increase in pressure inside the skull. This is a separate condition from a migraine but because it manifests in a pressure headache, the doctor may need to rule it out before proceeding with migraine treatment.

Abnormal reflexes

If you’re experiencing difficulty walking and performing regular activities, experience weakness on one side of your face or body or walk unsteadily, these could be signs of a condition like multiple sclerosis or another autoimmune disease.

Brain aneurysm

This is a weak spot in a blood vessel in the brain, which fills with blood and bulges outwards. In some instances, these can put pressure on various nerves and cause migraine-like headaches. While most brain aneurysms aren’t dangerous, in rare instances they can burst and cause bleeding in the brain (also known as a hemorrhagic stroke). If your headache is accompanied by dilated pupils, blurred or double vision, drooping eyelids or difficulty speaking, it’s important to rule out an aneurysm before starting treatment for migraines.

Other brain conditions

Since migraines occur and are caused by various events that take place mostly in the head, doctors often ask for an MRI simply to rule out brain injuries, fluid in the brain (called hydrocephalus) and strokes. Once these have been eliminated, the doctor can safely treat you for migraine without running the risk of overlooking a major medical condition.

Eyes and ears

Because these are located in the skull, they are in a primary position for injuries or infections to cause headaches resembling migraine. Usually, if the results show a problem with the eyes or ears this can be addressed first, which may help to reduce the incidence of migraine in the patient.

Headache complications

Even if you’re a long-time migraine sufferer, it’s essential to get medical attention if you experience any of these complications or side effects: 

  • Increased migraine intensity 

  • A new headache in a patient suffering from cancer 

  • Recurring headaches in patients with chronic conditions, due to immuno–suppression 

  • Regular headaches that began recently, especially after the age of 50 

  • Headaches that don’t respond to migraine medication 

  • Persistent headache and fever, or pain after a head injury 

Having said this, it’s not necessary to consider MRI even if you have regular migraines but experienced no changes in their pattern, other medical abnormalities, or only have mild headaches intermittently. Since 90% of the US population have headaches at some point, it’s unlikely that a gentle headache will require an MRI.
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