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Does my MRI for migraine show serious brain issues?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am 52 years old and have had a magnetic resonance imaging (MRI) for worsening migraines for the last six months. I have had migraines for 31 years. The finding was a few foci of T2 and 3 mm T2 prolongation within the left frontal subcortical white matter.

No associated restricted diffusion or abnormal enhancement. No additional parenchymal signal abnormality. The ventricles and midline structures are of normal appearance. Impression or conclusion: Minimal left frontal chronic microvascular ischemic changes. No findings of an acute intracranial process or abnormal enhancement.

What does all this mean? My neurologist said to take seizure medicine for the migraines, and my brain is fine. Currently, I am taking 12.5 mg of Amitriptyline every day and Sumatriptan when needed.

Please help.

Thank you.

Answered by Dr. Anshul Varshney

Hi,

Welcome to icliniq.com.

See, your magnetic resonance imaging (MRI) report is normal (attachment removed to protect patient identity) and has nothing to get worried. I would like to know a few things about your headache:

  • What is the onset, severity, and site?
  • Any associated vomiting?
  • What is the frequency?
  • How does your migraine improve?
  • Which seizure medicine are you taking? Is it Topiramate?

Revert with the asked details for better help.

Thank you.

Patient's Query

Hello doctor,

Thank you for your reply,

I am not taking the seizure medicine. I am going through perimenopause, so I think that is what is making them worse. My migraine starts very fast now, usually on the right side of my head over my eyebrow. I have to take 100 mg of Sumatriptan and six Tylenol to stop. I used to have two in a month, and last month had 13.

  • What is the normal magnetic resonance imaging (MRI)?
  • Do many 52-year-olds have the same findings?
  • Does it mean I have had small strokes on the left side, and something is wrong with the white matter?

Please help.

Answered by Dr. Anshul Varshney

Hi,

Welcome back to icliniq.com.

It is unlikely to be due to ischemic changes in your brain. This looks like a migraine headache to me. Moreover, a positive response to Sumatriptan and Tylenol favors the diagnosis of a migraine.

Menopause can cause precipitation of a migraine. I would recommend in such a case scenario to start on tablet Flunarizine 10 mg daily at bedtime, and very soon, your migraine headaches would disappear.

I hope this helps.

Thank you.

Answered byDr. Anshul Varshney

Medically reviewed byiCliniq medical review team

Published At May 29, 2018
Reviewed AtMay 14, 2026

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