Dr. Ghayur Abbas
Neurosurgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have had nausea for three weeks. There are no other symptoms like diarrhea and vomiting. I consulted a specialist doctor, and all the blood tests were normal. After the appointment, moderate to large stool burdens were cleaned with PEG (percutaneous endoscopic gastrostomy). This, however, did not resolve nausea. However, I started having a mild pressure-like headache for two days. Is this something I need to get an MRI (magnetic resonance imaging) on? Is there any chance of a possible brain tumor, considering I have had nausea for so long? I started taking Omeprazole three days ago, which was ineffective. Please advise.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
From your history, I do not think there is a need for MRI (magnetic resonance imaging). Just having nausea does not indicate that it is because of brain pathology. Patients with brain issues present with other symptoms, like morning headaches, deterioration of consciousness, fits, etc. Nausea could be more likely due to gastric upset.
Hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the response.
Then what could be the reason for the pressure-like headache that started two days ago? I just want to make sure a brain tumor would likely not be present with nausea first, then headache two weeks later.
Hello,
Welcome back to icliniq.com.
I understand your query and concern.
Assuming a brain tumor based on nausea or headache is not wise enough. Headaches could be due to so many causes. Furthermore, headache or nausea related to the tumor is seen mainly in the morning, which is relieved after vomiting. So I am not in favor of jumping to conclusions about tumors based on headaches or nausea. If you still have any worries, you can do MRI (magnetic resonance imaging) for your reassurance.
Hope this addresses your queries.
Thank you.
Patient's Query
Hello doctor,
Thanks again.
Recently I had a dizzy or fatigue-type feeling accompanied by headaches. The nausea is constant throughout the day. I recently had a brain MRI without contrast. Is this a reliable method to rule out all possibilities of tumors? Or do I need to schedule a brain MRI (magnetic resonance imaging) with contrast? What could be the reason behind all these symptoms? Last week, I went to an ENT (ear, nose, throat) doctor, and he said the symptoms were not due to my ears.
Hello,
Welcome back to icliniq.com.
I read your query and understand your concern.
MRI (magnetic resonance imaging) is a reliable method of ruling out any tumor or structural lesion in the brain. If the MRI brain is normal, you do not have to worry. Headaches could be due to multiple causes, most benign or harmless. Some patients suffer from migraines, which have headaches associated with nausea. Migraine is not a dangerous thing to be worried about. What I suggest is to maintain your sleep pattern and do regular exercise. Drink plenty of water. I do not think there are any issues with your brain. You may have gastric issues, which may cause nausea.
Hope this helped address your concern.
Thank you.
Patient's Query
Hello doctor,
Thank you for the detailed answer.
I think I had an endoscopy or colonoscopy yesterday, and nothing was apparent. Do you think pancreatic cancer could cause constant all-day nausea and fatigue or headaches? Nausea also started before the headaches, so I do not think it is because of a migraine. Please help.
Hello,
Welcome back to icliniq.com.
Honestly, I will not be able to comment on pancreatic issues. But I do not suspect any tumor, even in the pancreas.
Hope this helps.
Thank you.
Patient's Query
Hi doctor,
I recently have been feeling some dizziness and vertigo symptoms. I feel a bit unstable when standing, and the floor feels like it is moving when walking. Also, I still have chronic nausea, but mostly sick after eating throughout the day. Some headaches, on and off. But again, I have already had the open MRI (magnetic resonance imaging) without contrast of the brain, which was normal. Is it possible this MRI without contrast could have missed a brain tumor?
Hi,
Welcome back to icliniq.com.
If MRI without contrast is normal, then this means there is no space-occupying lesion in the brain. If there was any tumor, then it should be visible on MRI. So do not worry.
Revert in case of queries.
Regards.
Patient's Query
Hello doctor,
Thanks again.
I just had another MRI with contrast today. The only comment was the following: Single punctate focus of increased T2-weighted signal intensity within the left frontoparietal subcortical white matter of doubtful significance. Should I be concerned about this? I have also attached the full report for you to check.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have seen MRI reports (attachments are hidden to protect the patient's identity). Single punctate focus is not of any significance at the moment. Sometimes artifacts can come on MRI, or sometimes there are increased signals in one or more points. There is no evidence of any tumor. So you do not have to worry at the moment.
Hope this addresses your concern.
Thanks and regards.
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Neurosurgery
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