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Post-Concussion: when is an MRI necessary?
ryan2188 posted:
My wife hit her head pretty hard almost 2 weeks ago on our kitchen table. She had been picking up something under it and as she stood up hit her head. About 5 days later she started having post-concussion related symptoms such as lingering migraines, different sized pupils, slight occasional numbness on other side of face, sometimes dizzy. I took her to urgent care about a week after the incident since this is when we noticed the symptoms may have been a cause of her hitting her head.

Urgent care doctor ordered a CT scan which came back negative. He then referred us to a neurologist for follow up. The neurologist was very quick, showed very little care, and acted like this was no big deal. Just gave her samples of Cambia (which is insanely expensive and most insurance companies don't like covering it) and also prescribed her nortriptyline to take before bed to help her sleep. He also ordered an MRI and to see him in 2 weeks.

My question is, if the CT scan didn't show hemorrhages or swelling, is the MRI absolutely necessary in this situation with these symptoms? My insurance company is making me pay a $300 down payment, $80 deductible, and $800 out of pocket costs just for one MRI and while I care about my wife more than anything in this world, I want to make sure I'm not dropping this money for no reason other than to line people's pockets (the way they've been treating us seems to indicate this).

If a patient hits their head, a week later has post-concussion symptoms, CT comes back negative, how important is it to get a follow up MRI? Are there major warning signs to look for? She has NOT felt any nausea or been throwing up and she has not lost vision or hearing even temporarily.

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