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What does "deep white matter small foci of chronic ischemic gliosis" mean? - Online Doctor Chats

Date : 02-Mar-2014
User rating for this question
Very Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
User:Had a brain MRI recently and one result was right frontal lobe subcortical deep white matter small foci of chronic ischemic gliosis. Can you explain in layman's terms what this means. I am a 63 year old male. Reason for MRI was concern about possible stroke due to some continued unsteadiness and left arm drift in a field test. No other physical signs of stroke.
Doctor:and I here to assist you today
Doctor:Let me read your query
Doctor:Give me couple of minutes
Doctor:ok got it
Doctor:It is not uncommon to see such changes in the MRI of the brain of a 63 yr old person
Doctor:More importantly why was the MRI done?
Doctor:are you with me?
User:As I explained there was concern by my primary care physician of a possible stroke. unsteadiness, left arm drift and some weakness in left side
Doctor:These changes observed in MRI represent small blood vessel problems
Doctor:that means that the small blood vessels in the brain are showing signs of ischemia (lack of blood flow)
Doctor:Your primary did the right thing
Doctor:There is a suspicion of stroke with the symptoms you complained off
Doctor:With these white matter changes the suspicion is stronger that there is a chance of impending stroke in future
User:I am a smoker and have stopped and all of the symptoms seem to be gone.
Doctor:So as a primary physician if I see these changes in my patient I would like to check the extent of damage
Doctor:since it is restricted to frontal area and there is a chance to spread to other areas I would surely address the risk factors leading to small vessel changes
User:The report also indicated small 4 to 5 mm focus of abnormal signal involving the inferior right thalamus
Doctor:Perfectly said, past smoking history leads to microvascullar changes
Doctor:Similarly diabetes
Doctor:High blood pressure also causes these changes
User:What part does diabetes play in this, I have never been diagnosed. I don't have high blood pressure either.????
Doctor:Ok that is good to hear
Doctor:I was in fact talking about long term diabetics and high blood pressure
Doctor:since you were not diagnosed yet, I would relate these changes to age and smoking history
Doctor:I think the best thing to do from now on is to prevent further damage
Doctor:by taking nutritious diet, exercise, mental well being
User:Now the big question, the diagnosis on the MRI was Thromboangitis obliterans(Buerger's disease.
Doctor:Positive thoughts, checking blood pressure, cholesterol and blood sugar
Doctor:TAO is associated with smoking
User:I assumed it was, now what?
Doctor:As I said to prevent further damage
Doctor:with the above measures
User:OK, but should I be worried if I do these things?
Doctor:What things
Doctor:Ok no you should not be worried
Doctor:As you had stopped smoking completely you are saved
Doctor:Wear protective foot wear and do not get hurt
Doctor:Practice exercise, meet a dietitian for nutritious diet
Doctor:Prevent infections, take necessary vaccinaations
Doctor:like Pneumonia, Flu, Tetanus
Doctor:Avoid cold environments because that aggravates the matter
Doctor:It leads to further vasoconstriction
Doctor:and deteriorate
Doctor:In future you should avoid drugs that lead to vasoconstriction, so you should remind the doctors that you have buerger's
Doctor:Are you with me?
Doctor:Did you follow?
User:Have tried to do most of the things
Doctor:Great you are on right track
User:OK this helps
Doctor:Do you have anything specific to ask me now?
User:Thanks for your advice. I guess not, I will be going to the neurologist in 2 weeks and just wanted some insight on the MRI
Doctor:I think we are running short of time
Doctor:As I said it is reflecting the changes of Buergers
Doctor:in the brain
Doctor:as expected and it is occasional white matter gliosis not extensive though
User:Thanks, I'll keep all this in mind as I followup with my doctors
Doctor:Fine. Hope this is a useful session
User:Have a good rest of the evening.
Doctor:Wish you Good health
Doctor:Bye for now
User:Good night
Doctor:Same here
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