Should I worry about MRI without contrast?

Last year I had a terrible derealization for about a month and had a MRI without contrast to rule out neurological issues. It came back clear.
On the other hand, I’ve been suffering from migraines for almost 7 years now and these past two months they are getting worse than ever. I do notice an obvious change in their frequency and pain level and when I went to a neurologist he put me on propranolol, but I’m supposed to wait for at least a month to notice any changes.

My question is, could they’ve missed something on the MRI because they didn’t use contrast last year? I am obsessing over this and everything is getting bad again, this new worry + my frequent migraines are really driving me crazy. I literally wish for nothing but another MRI, but I’m not ready to do again what I’ve been doing to the people around me for the past 10 years.

Migraines are really tricky. You can have them one way for a very long time and then they may change in location, frequency, intensity, etc. and maybe just once or twice before they’re back to normal.

If you aren’t having any other symptoms, they likely are just bad migraines but it sounds like you and your docs are doing a good job of staying on top of things. Give the meds a chance to work before hitting the drawing board.

FWIW, I’ve had migraines for over 11 years now and they change sometimes too. I’ve had a few MRIs along the way to make sure everything is fine - the last one was after I had one so bad I ended up in the ER - but all has always been well and I don’t think any were with contrast.

Thank you so much for your answer.

I have no idea why this month seems to be so bad for my migraines but I hope the new medicine will show some results soon.

In the end I think I just needed reassurance, cause a few days ago I ended up on the horror side of reddit and read tons of stories about migraines ending up to be strokes or tumors, so you know how that goes…

I don't know if it's hot where you are, but that can be a trigger. Stress can as well - my migraines are usually caused by tension so when I'm stressed they for sure get worse.

I understand your fear though. When I went to the ER with my one migraine I thought I was having a stroke. It was the first time I'd had an aura and had a blind spot from a migraine, and I was also having a lot of trouble forming sentences. The ER doctors were very certain it was "just" a migraine and I had an MRI afterward and a visit with a neurologist and that was the finding as well. And, oddly enough, that was about eight years ago and I haven't had one that bad since, nor have I had aura or blindness with my migraines since either (knock on wood!). So they can definitely be very weird.

I hope you are able to get your meds figured out and put these awful things behind you! Or at least get them better managed.