If your primary care physician suspects that you have an abnormal structural condition in your head and neck junction, they can order an MRI to confirm their suspicion so they can give you a referral to a neurosurgeon and/or a neurologist, based on the findings. Sometimes, however, structural issues aren't discovered in an MRI scan unless there are multiple images taken. Here are a few things to expect when having an MRI scan for a suspected structural abnormality in your head and neck junction.
The junction where your head and neck meet is called the craniovertebral junction. Any structural abnormalities could result in compression of your brain stem and/or the blockage of the cerebral spinal fluid. When someone with structural abnormalities turns their head or moves their neck, the abnormal bony structures don't move as they should and, therefore, could cause debilitating symptoms that affect the autonomic systems. Several structural abnormalities include:
- Chiari malformation
- Basilar invagination
- Eagle's syndrome
- Craniocervical instability
- Atlantoaxial instability
When ordering the MRI, your primary care physician may list the conditions they suspect on the MRI order. Sometimes, this helps rule out various possibilities as well, so don't be too alarmed if you read the order before the MRI.
Specific Instructions to Expect
When it comes to structural abnormalities in the head and neck junction and trying to get imaging done, you'll be asked to position your head in different ways throughout the MRI scan. This type of MRI scan imaging is called MRI of the neck with flexion and extension. Flexion is the position when you lower your chin to your chest. Extension is the position when you tilt your head back. Pay close attention to what the attendant asks of you during the MRI scan so you perform the correct movements.
The MRI scan may also involve a CSF flow study with a special type of MRI called a cine MRI, with cine being short for cinematographic. This is done to measure the intracranial pressure pulsatility and to determine if the cerebral spinal fluid flow is adequate. The intracranial pressure pulsatility correlates with your pulse and blood pressure. So, you can expect to wear a blood pressure cuff while you have the MRI scan done if the MRI scan order includes a CSF flow study. Also, this study typically takes longer to scan due to it being in video form as opposed to individual photos.