Q. I have high platelet levels with migraine. Kindly interpret my MRI report.

Answered by
Dr. Kapil Gupta
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 21, 2020 and last reviewed on: Jan 21, 2021

Hello doctor,

I have migraines for months was put on medication, but it was not helping. Now I am on preventative and emergency medicines. I have done an MRI, which showed abnormal results. Blood work showed platelets of 544. I was asked to consult a hematologist. What can it be?



Welcome to icliniq.com.

I have reviewed the reports of your MRI (magnetic resonance imaging) and blood (attachment removed to protect patient identity). They are incomplete reports, and I would like you to share the other sections of the reports as well for me to have a clear picture.

Well, the recurrent headaches most commonly diagnosed as a migraine can have other causes as well. One reason can be the excessive production of cells in your body, a condition known as polycythemia. The excessive cells produced on polycythemia lead to clogging of your blood vessels and decreased blood supply to the brain and other organs leading to headaches, dizziness, etc.

From your MRI brain report, I see that they have mentioned marrow changes in your spine, and also the increased platelets lead to a suspicion of the following causes:

1) Polycythemia vera.

2) Essential thrombocytosis.

3)Secondary polycythemia.

Another cause can be chronic myelogenous leukemia.

Now to rule out all these causes, the following tests are required:

1) Complete blood count.

2) Peripheral smear.

3) Bone marrow aspiration and biopsy if needed as decided by the hematologist.

4) Presence of JAK2 mutation if needed to be decided by the hematologist.

5) Serum erythropoietin levels.

6) Leucocyte alkaline phosphatase levels.

Before proceeding with all these tests, I recommend you see a hematologist who would do a physical examination to check for various other signs of the conditions mentioned above. Based on that, a hematologist would advise you on the next plan of action.

Do not panic. All these conditions that I have mentioned can be treated.

I hope this helps.

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