Incidental Findings and Normal Anatomical Variants on MRI of the Brain in Adults for Primary Headaches

Randolph W. Evans, MD


Headache. 2017;57(5):780-791. 

In This Article

Case History

Case 1

This is a 32-year-old male with a history of increasingly frequent episodic migraine. MRI of the brain was normal except for a 7 mm pineal cyst. Another MRI of the brain 5 years later for chronic migraine showed no change in the size of the cyst.

Case 2

This is a 27-year-old male, the brother of case 1, with a history of headaches consistent with migraine without aura since childhood. Headaches have increased to twice a week in frequency. Past medical history is negative. Neurological examination is normal. Magnetic resonance imaging (MRI) of the brain shows a left anterior cranial fossa arachnoid cyst measuring 1.2-cm anteroposterior by 1.6-cm transverse by 1.5-cm craniocaudad without significant parenchymal compression. He is placed on a triptan with a good response.

Questions.—How often and which incidental findings (IF) are present in adults without neurological problems and migraineurs? In alphabetical order, what are some incidental findings and anatomical variants which may be encountered?