MRI Scan on Head: What Does It Show and Why?

If you have been advised to arrange an MRI scan on your head, you may assume that one scan examines everything from your brain and eyes to your ears, sinuses and neck.

That is not always the case.

In everyday language, “head MRI” is often used to mean a brain MRI. However, the head contains several closely positioned structures, and different symptoms may require different areas to be examined in greater detail.

A standard brain MRI focuses mainly on the brain and structures within the skull. More specialised imaging may be needed if the clinical question relates to the inner ears, eyes, pituitary gland or blood vessels.

Understanding this difference can help you ask the right questions and make sure the examination is focused on what needs to be investigated.

An MRI scan on the head usually refers to a brain MRI. It creates detailed images of the brain and structures inside the skull and may be used to investigate neurological symptoms, assess an earlier finding, plan treatment or monitor a known condition.

However, it does not automatically provide a detailed assessment of every structure within the head. The exact area and imaging protocol should be selected according to your symptoms and the clinical question.

The terms are often used interchangeably, but they are not always equally specific.

A brain MRI is a defined examination focused on the brain and structures inside the skull.

A head MRI is a more general phrase. Someone using this term could be referring to imaging of the:

• Brain
• Pituitary gland
• Inner ears and hearing nerves
• Eyes and eye sockets
• Blood vessels
• Facial structures
• Head and neck area

These structures are close together, but they may require different MRI protocols.

NHS imaging services list brain, pituitary, orbit and internal auditory meatus MRI examinations separately. This reflects the need to tailor the images to the structure being investigated.

An MRI examination is planned around a specific clinical question.

The radiographer does not simply capture every possible image of the entire head. Different sequences are selected to show particular tissues and structures.

The question might be:

• Is there a structural cause for these symptoms?
• Does one area of the brain require closer assessment?
• Could a particular nerve be involved?
• Has an earlier finding changed?
• Does the pituitary gland need detailed imaging?
• Do hearing symptoms require focused assessment?
• Should the blood vessels be examined?

A routine brain MRI may capture parts of nearby structures, such as the eyes, ears and sinuses. However, seeing a structure within an image does not mean it has been examined using a dedicated protocol.

A standard brain MRI scan usually provides detailed images of the:

• Cerebrum
• Cerebellum
• Brainstem
• Ventricles
• Major structures within the skull
• Surrounding tissues included in the scan

The images may help a radiologist assess the structure of the brain and identify changes requiring further attention.

According to the NHS, MRI scans may be used to investigate symptoms, support diagnosis, plan treatment and monitor how well treatment is working.The result must still be interpreted alongside your symptoms, medical history and any other relevant tests.

Some concerns require more focused imaging than a routine brain MRI.

Persistent one-sided hearing loss, unilateral tinnitus or certain balance symptoms may sometimes lead to focused imaging of the internal auditory meatus.

This area contains nerves involved in hearing and balance. A dedicated examination can provide more focused images than a general brain MRI.

An acoustic neuroma, also called a vestibular schwannoma, is one reason this area may be assessed. However, these tumours are uncommon, and similar symptoms can have many other causes. NHS acoustic neuroma guidance

VitalScan’s existing guide explains more about tinnitus and when imaging may be considered.

The pituitary is a small gland located at the base of the brain. It helps control several hormones within the body.

When the clinical question relates specifically to the pituitary gland, a dedicated pituitary MRI may be required. The assessment may also involve blood tests and advice from an endocrinology specialist.

A standard brain MRI is not automatically a complete pituitary assessment.

Some visual symptoms may involve the eyes, optic nerves or structures behind the eyes.

Dedicated orbital imaging may be requested when these areas require detailed assessment. Although the eyes may appear on a routine brain MRI, this does not mean the eye sockets and optic nerves have been examined using a specialist protocol.

Sudden loss of vision requires urgent medical assessment rather than waiting for a routine private scan.

Some symptoms or previous findings may require assessment of blood vessels in the head.

MR angiography is a specialist MRI technique used to examine blood vessels. It may be performed with or without a contrast injection, depending on the clinical requirement.

A routine brain MRI should not be assumed to include a complete examination of the arteries and veins.

The face, jaw and sinuses are within the head, but they are not necessarily assessed in detail during a standard brain MRI.

If your symptoms mainly involve facial pain, jaw movement, nasal blockage or recurring sinus problems, a different examination or specialist assessment may be more appropriate.

The correct investigation depends on the symptoms and the structure that needs to be examined.

A head or brain MRI may be considered when a healthcare professional needs detailed structural information about the brain or another area within the head.

The decision is usually based on the complete pattern of symptoms rather than one symptom alone.

The healthcare professional may consider:

• When the symptom began
• Whether it started suddenly or gradually
• How frequently it occurs
• Whether it is becoming worse
• Whether it affects one or both sides
• Whether other neurological symptoms are present
• Your medical history
• The findings from previous examinations

You do not need to diagnose yourself. Clear information about what you are experiencing can help determine whether imaging is appropriate and which type of scan may be required

Sometimes, but not always.

A brain MRI may help investigate headaches when the clinical history or examination raises concern about a possible secondary cause.

However, many headaches are migraines, tension-type headaches or other primary headache disorders that do not produce structural changes on an MRI.

People with a diagnosed primary headache disorder should not be referred for neuroimaging solely for reassurance. Further investigation may be considered when there are new, unusual or concerning features.

A healthcare professional may ask:

• Did the headache begin suddenly?
• Has its pattern changed?
• Is it becoming more frequent or severe?
• Is it accompanied by vomiting without another clear cause?
• Are there changes in vision, speech or balance?
• Is there weakness, numbness or confusion?
• Has there been a recent head injury?
• Is there a relevant history of cancer or reduced immunity?

The purpose of the MRI is not to prove that a headache exists. It is to assess whether a structural finding could help explain it.

Dizziness has many possible causes and does not automatically mean there is a problem within the brain.

It may relate to:

• The inner ear
• Migraine
• Medication
• Blood pressure
• Vision
• Balance disorders
• The nervous system
• Other medical conditions

A clinical assessment is often needed before imaging is considered.

If MRI is recommended, the correct examination may depend on whether the dizziness is accompanied by hearing changes, one-sided tinnitus, visual symptoms, loss of coordination or other neurological signs.

Dizziness that begins suddenly with weakness, speech problems, facial drooping or severe loss of coordination requires urgent assessment because it may indicate a stroke.

A brain MRI can show a possible tumour or another mass within the brain.

However, the scan may not provide a complete diagnosis on its own. Further tests may be required to determine exactly what the finding represents.

These could include:

• Additional MRI sequences
• Contrast-enhanced imaging
• Another type of scan
• Specialist assessment
• Follow-up imaging
• A biopsy

The NHS notes that headaches can occur with brain tumours, but it is unusual for a headache to be the only symptom. Being referred for a brain scan also does not mean that something serious will be found. NHS brain tumour guidance

Parts of the sinuses may be visible on a brain MRI because they are located close to the brain.

However, a routine brain MRI is not automatically a dedicated sinus examination.

If your main symptoms involve facial pressure, nasal blockage, discharge or recurring sinus problems, a clinical or ear, nose and throat assessment may be more appropriate. A healthcare professional can decide which type of imaging, if any, is needed.

A standard brain MRI does not normally provide a detailed assessment of the cervical spine or wider neck.

If symptoms include neck pain, arm weakness, tingling or numbness, separate or additional cervical spine imaging may be considered.

The brain and cervical spine are different examination areas, even though some neurological symptoms can involve both

A normal result means the radiologist has not identified a significant structural abnormality within the areas examined using that particular MRI protocol.

It does not necessarily mean:

• Every structure within the head was assessed in equal detail
• Every possible neurological condition has been excluded
• Your symptoms are not real
• No other assessment will be needed

Some conditions do not produce visible structural changes. Others may require a different investigation or more focused imaging.

A normal result can still be useful. It may provide reassurance and help your healthcare professional decide what to consider next

Sometimes an MRI identifies a change unrelated to the original reason for the examination. This is called an incidental finding.

An incidental finding may:

• Require no further action
• Need comparison with previous imaging
• Require a more focused scan
• Need follow-up imaging
• Be discussed with your GP
• Require specialist assessment

Avoid trying to interpret individual MRI images without the radiology report. The significance of a finding depends on its appearance, location and relationship to your symptoms

You do not need to know the medical name of the scan you require.

Explain:

• Your main symptom
• Where you feel it
• When it began
• Whether it started suddenly
• Whether it is becoming worse
• Whether it affects one or both sides
• How long each episode lasts
• Whether you experience hearing, vision or balance changes
• Whether there has been an injury
• Which tests or treatments you have already had

Instead of saying:

“I need an MRI scan on my head.”

You could explain:

“I have had headaches mainly behind my right eye for three months, and they have recently become more frequent.”

This gives the clinical team more useful information about the question the scan may need to answer

Do not wait for a routine MRI appointment if you experience:

• Facial drooping
• Sudden weakness or numbness on one side
• Difficulty speaking
• Sudden confusion
• Loss of consciousness
• A first seizure
• A sudden, extremely painful headache
• Sudden loss of vision
• Severe symptoms following a head injury
• Rapidly worsening neurological symptoms

Call 999 or attend A&E in an emergency. NHS guidance advises immediate help for a sudden, extremely painful headache or a first seizure. NHS brain symptom guidance

\An MRI scan on the head is not automatically one examination that checks every structure above the neck.

The most useful scan is the one designed around your symptoms and the clinical question that needs answering.

This may be a standard brain MRI or a focused examination of another structure. Providing clear information can help ensure that the correct area and protocol are considered.

At VitalScan, we provide private brain MRI scans in Milton Keynes, with images reviewed by experienced consultant radiologists.

If you already know which examination you require, you can book online. If you are uncertain whether a standard brain MRI is appropriate, contact the VitalScan team before booking.