moms of kids with BI, have a question

Discussion in 'General Parenting' started by Tiapet, Apr 24, 2012.

  1. Tiapet

    Tiapet Old Hand

    Those of you who have kids with brian injuries I have a question. Which is more of what I want to ask for, and MRI or a CAT scan? We're trying to find out if middle difficult child has any damage (suspected due to anesthesia during a surgery) that might be causing some of the issues she is having that we haven't been able to figure out and slowly started manifesting over the years since the surgery.

    A little back history may or may not help. She's been through all the psychiatric testing and we know all her behaviors, although it is quite possible that some of the behaviors are also contributable to this suspected problem as well. What we see is more of cognitive issues that we can't figure out. Like things of "not getting it". You know the saying of teaching a child something a thousand times before they actually learn it? Yeah well that's just one of the things that doesn't always happen. Some of the others are connections to consequences of her actions, acting inappropriately or saying inappropriate and not even realizing that it is so (I know this might be a spectrum issue too but need to rule out if it's a cognitive thing too). There are probably many other things I'm not putting down here to. She tests out mostly on the low end of average on IQ testing but in sub tests we see weakness in particular areas. It very strange over all in that she acts like a child that may have mental retardation yet her testing doesn't show it. Hence, beyond all the other stuff, why we really need to see if there is something going on inside her brain that we are fighting and just don't know it.

    The reason I have asked this question as well is because her psychiatrist sent a referral to neurologist but they won't take it from him (for the purpose of having one of these tests done). The neuro wants the referral to come from the primary doctor. Go figure. In order for that to happen it will take quite some time because she has a brand new doctor and that doctor will have to get all her old medical records which will include 11 years of orthopedic records (which is where the surgery records are that has the instances), then the primary doctor will have to search through those records to pull out exactly the information the neuro will need and send just that. A very time consuming process which means it may take up to 3 months before all is said and done before we even get in to see the neuro, let alone get the test done. So, we're thinking that if we can get the psychiatrist to just order the "test" itself (cat or mri, hence why I ask which it is I want) and work with that first then refer out if there is something detected then it would be a much quicker process.

    So which test will show us what we need to know?
  2. jal

    jal Member


    I don't have a child with-a brain injury, but we wanted to rule that out a few years ago as he had wacked his head a couple of times and required stitches when he was younger. We had an MRI. That will show you the most detail, especially with regards to the brain. It will show more than a CT scan. If something were to show up on a CT scan then they would probably send you for an MRI.
  3. buddy

    buddy New Member

    I just get so frustrated that it would take so long to check out something in a child's brain! I am not a medical expert, I can only say what our experiences have been. There are different levels of CAT scans and MRI's and there are also PET scans that can help look at the function of the brain. A cat scan is more of an xray (to me) and an MRI, especially some of the more sensitive levels can look at each of the structures in detail. It takes longer to get an MRI for that reason. For my son's issue (cavernous angioma) unless quite large a CAT scan can't find it, and only a certain kind of MRI can find it. Along with the levels there is also the choice to use some kind of contrast or not. This makes things show up like lumps or blockages.

    For your daughter if there is damage on a smaller cell level, it may not show up. Just like with mild concussions. PET scans view which areas of the brain are active during different activities. I can imagine insurance would only cover it under certain circumstances. So, clearly I can't recommend, but it seems like...CAT scans can find bigger things, MRI is more detailed....I'd hope for an MRI, but could be way off base.
  4. Tiapet

    Tiapet Old Hand

    Thanks ladies. I have an appointment this afternoon so I wanted to go in with her worker, who I had already discussed doing this with and she thought was a good idea, and just ask him to jump to seeking an MRI right from him so it doesn't take forever.
  5. ThreeShadows

    ThreeShadows Quid me anxia?

    Hi, Tiapet! Google 'neurometric brain mapping'.

    Is the psychiatrist a psychiatrist? Did his referral say "spotty cognitive difficulties following anesthesia on (date of procedure)"? The neuro should have accepted the refferal from a pshyc. unless he felt like psychiatric. was telling him what procedure to order. Md ego got in the way? The neuro will probably order a regular MRI with contrast, looking for structural abnormalities. Depending on the results, if normal they may want to consider neurometric brain mapping. If abnormal, he may consider a functional MRI or PET scan.

    We have a friend whose life was totally destroyed following anesthesia. It caused hyperthermia and fried his pituitary. The anesthesiologist had conjunctivitis and contaminated the product!
  6. Tiapet

    Tiapet Old Hand

    Yes it was a psychiatrist. I have no idea what he wrote in his referral. All I do know is the neuro called and said "we don't treat behavior problems" to which I said that wasn't the issue as the psychiatrist was treating them and that we were looking for cognitive and other problems to which they then said " we have to have the primary care doctor refer".

    Thank you for that bit of information. I will give it to the psychiatrist in my explanation so IF he will write an order for an MRI he wi write if for perhaps the neurometric brain mapping (as that makes much more sense). If he won't then at least perhaps a MRI with contrast or functional. If all that fails or in addition to it if it doesn't, I probably can get her primary care doctor to write for what ever is not written for next week when we see her as she is very nice, listens and understands the whole situation. Even though difficult child has not seen her before, she is oldest difficult child and my doctor so has inside information on family dynamics and situations already as well as I know her very well enough to know what to expect from her, etc.