How Effective are MRI Scans?

 

 Left: the hippocampus of the human brain.

 Right: a seahorse, the Latin for which is 'hippocampus.'

 

Back in 2009, after a year or two of badgering my GP and a range of different psychologists, I found myself on a Disability Awareness training course via work. I spoke to the trainer and explained my difficulties at the time: undiagnosed memory issues, probably the cause of a head injury during a complication at birth, an obvious misdiagnosis of dyslexia, an inappropriate position in work, a support system that didn’t really know what to do with me and an array of problems at home and in social life.

The Trainer gave me his email, and eventually put me in touch with a neuropsychologist who worked in his building. We’ll call her GW. She met with me and ‘understood the assignment’ immediately: we set up a series of sessions to involved running the tests of the psych assessment, and looking at what can be done to address certain issues in my life.

When the assessment was complete, there were a list of perhaps 10 recommendations made. One of these was for an MRI scan to be carried out.

Weeks later, this was done, but the results had come back negative. They could find no abnormality. The MRI team had obviously not read the psych assessments or any notes at all about me, as their reply claimed, ‘this must be reassuring for the patient.’

It wasn’t.

Now, the head injury occurred during my delivery, in the same hospital where I was assessed, and where the scan was- 26 years later- carried out. I’m not saying there’s a huge inside job, but I am saying that from a scientific perspective it would be good to get a second opinion. I requested a copy of the scans and found a trusted NHS worker to pass it on to a neurologist he knew. The response was the same: no abnormality found in the physical structure of the brain.

This has always played on my mind. A decade or so after the scan, I still fail to accept this theory. I sustained a massive head trauma to the rear of the skull, the exact area that would be most likely to impact on the hippocampus and memory. The memory difficulties were first picked up on at 4 years old and they have never been ameliorated. How could one not be the cause of the other? How could that damage not have appeared on the scan?

More recently, I decided to dive back into this topic. I explained the above to brain injury charity Headway.

“With scans, it is important to be aware that they are not able to detect every brain injury,’ says Helpline Consultant Penny. ‘Certain types of brain injury, particularly if it has occurred at a microscopic level, are not detected by scans, and it is also less likely for an injury to show if it occurred a long time ago.

“There is some information about this on page 9 of our factsheet ‘Scans and tests after brain injury.’

“We have the understanding that MRI scans are most effective when there is a prior understanding of what to look for. For example, if it is thought that there has been a particular type of injury to a specific region of the brain, the scan can be set up to look for this, as opposed to a more general scan which may miss something. Certainly you are right in believing that scans should not be used as the definitive answer as to whether someone has an acquired brain injury or not.”

Going forward, to use the office meeting cliché, it would be great if I could get another scan, preferably not from Oldham NHS, to eliminate any potential bias (Oldham NHS performed the delivery where the injury was acquired). a local university has their own MRI machine, but having emailed them a few times over the years I never got very far. If any experts want to chime in, I’m all ears.