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Getting frequent headache, runny nose and fever. CT scan showed frontal white matter ischemic changes. Serious?

Nov 2013
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Hi Doctor,

I am XXXXXX from Bangalore. My Mother-in-law, XXXXXX aged about 55 years, had fallen 3 times in past 3 weeks without her knowledge for a short span of 2 to 3 seconds. Also, from past few days, she is getting frequent head aches, running nose, sniffs and occasionally fever too.

Contacted General Doctor in regards, and the Doctor advised to get Sugar, BP, Urine, CBC and CT Brain tests to be done. We got all the tests done, all the reports are normal (i.e No BP, No Sugar etc). But, CT Report shows as below :-

CT Scan of Brain (Plain):-
Technique - Multi Slice trans axial scans were performed from the base of skull upwards.
Findings - Ischaemic changes noted in left frontal white matter, Left basal ganglia calcifications. The other sections of the Supratentorial brain do not reveal any area of altered tissue density in the cortical or white matter substance. The deeper nuclei are normal. There is no evidence of SOL/ Bleed.
The Ventricular system is normal. No Shift of midline structures. Subarachanoid cisterns and sulcal spaces appear normal. Persistent cavum septum pellucidum and vergae.
Brain stem appears normal. Posterior fossa structures appear normal. Fourth ventricle is normal. Both the cerebelli and cerebellar peduncles are normal.
Bony Skull:- No fracture is seen. Right Maxillary sinus mucosal polyp. Left maxillary sinus mucosal thickening. Other included sections of the PNS are normal.

Please help me by knowing the reasons for this and also best possible remedies to keep her fit and fine. She is a strong lady and her health is well maintained till now. We are worried on this report now.

Kindly do help to treat her well and easily, as we do not know about the seriousness this problem might be.

Thanks and Regards,
Posted Sun, 28 Apr 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 1 hour later

Thank you for posting your query.

I appreciate the detailed CT brain reports.

The findings on the CT brain are suggestive of ischemia (lack of proper blood flow) to the brain. As you mentioned, the common causes for the same are BP and sugars. Other causes to be looked for are high cholesterol (lipid profile) and high homocysteine. Both these can be checked in blood tests.

At this stage, no need to worry. However, if left untreated, it can lead to brain stroke, referred to as paralysis.

Her falling episodes could also be related to the brain problem, as ischemia of brain can lead to seizures (fits).

Treatment at this stage would consist of blood thinners such as aspirin and anti-epileptic medications such as carbamazepine or levetiracetam.

I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website:
My email: YYYY@YYYY
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