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High blood pressure, acute pain in the head and eye. Treated for Temporal arteritis. Have breast cancer. Chronic microvascular ischemic changes in the MRI

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I have been suffering with acute pain in the temple, eye, and head ( all on the left side) and high blood pressure. Because of the symtoms I was treated for Temporal Artritis. I recently had an MRI and MRA. There were a few punctate specks of Flair within the pons, and a few specks of Flair hyperintensity involving primarily the subcortial white matter of the frontal lobes. The findings are typical of mild chronic microvascular ischemic gliosis. Could this be the cause of my intense pain. What an you take for it? I also had breast cancer, and I have members of my family with MS. Are either of these something to be concerned about.
Posted Tue, 8 May 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 10 hours later
Thanks for the query

Regarding the new onset hemicranial headache and considering your age, I personally agree with the diagnosis of temporal arteritis and you need to continue on the treatment for the same.

Regarding the changes seen on the MRI, I feel that the chronic microvascular ischemic changes (Microvascular leukariosis) is a common finding in the aging brain and is thought to be due to the chronic ischemic effects of small vessels “pruned”( made smaller) by small vessel vasculopathies (issues with the vessels) such as hypertension or diabetes.

Rarely, vasculitis of the brain can present with headache and similar MRI changes. However this is nothing to do with multiple sclerosis or Breast cancer.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your Neurologist. I personally feel you are suffering from temporal arteritis and you need to continue on treatment to prevent the complications like blindness and stroke. Biopsy of the temporal artery may be required to confirm the diagnosis.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
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