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Shakiness and pain on right side. Is this related to microvascular ischemic disease of brain?

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Practicing since : 1981
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GP had MRI ran do to dizziness, falling and balance and cooridation for about 5 day, Hospitalized and diagnosed with Microvascular Ishemic Disease of Brain - Severe. I have high cholesterol, Diabetis and controlled high blood pressure i am on Medicine for all three. Now doing inhome physical therapy - 3 times a week and balance and dizziness is much better. Use walker and am now trying to get around home on cane. GP on last visit did not discuss if dizziness, falling, balance/coordination problems were caused by this disease so I wonder did I have a XXXXXXX stroke as I had a hemmorratic stroke 10 years ago and some of these symptoms I am experiencing , I also had with my stroke. I have had a shaken/slightly woozy feeling /slight pain on right side about 5 times lasting about 45 seconds since released from hospital this happened while showering, watching TV and walking in kitchen. Is this part of the disease? I do not have another appointment for 2 months with GP and afraid to go very far even with my walker as I lose my sense of balance and surrounding when these episodes happen. , Would you advise me just to go on with my life and hope for the best. As that is what I felt my GP was trying to get across at my last office visit. I do not feel secure enough yet to go any where on my own., like taking a City bus or walking 5 blocks to nearest grocery store. Also I do not drive, so am dependent on others for transportation. Also, so many people said this disease often develops into Dementia, is that a myth or true? I hope you understand my confusion. I just need some honest direction with this disease. I am consently thinking I may have been diagnosed wrong. Is that wishful thinking? Thank you so much for any help you can give.
Posted Sun, 29 Jul 2012 in Brain and Spine
Answered by Dr. Anil Grover 3 hours later
Hi there,
Thanks for writing in.
I am a medical specialist with an additional degree in sub specialty of cardiology.
I read your mail with diligence.
Risk factors for microvascular disease of brain:
Most common cause is atherosclerosis therefore risk factors include:
* denotes you have it, - you do not +/- we do not you as yet.
1. Hypertension*
2. Diabetes Mellitus*
3. Dyslipedemia* (High total cholesterol, LDL & triglycerides and low HDL)
4.Increasubg age*
5. Obesity +/-
6 Stress +/-
7. Atherosclerotic thrombo-embolic disease of neck vessels+/-
5 and 6 you can fill in and for 7th, an echoDoppler study is needed
Usually, in microvascular infarcts the course is towards recovery, some defects last for less than a day (Transient Ischemic Attacks TIASs), some last for few days to six months (Reversible Ischemic Neurological deficits RINDs),
Prevention of Further Epidsodes.
First and foremost is treatment of underlying causes which is on. Second is modification of life style. Ischemic microvascular disease can be prevented with lifestyle modification, exercise and healthy diet. It is best to avoid fatty and high cholesterol foods as they contribute to the plaque formation along the vascular walls that may trigger ischemia. Reversal of the disease is difficult with the high risk of progression, hence preventing its occurrence is better than providing treatment to the condition. Yes one should get on with life-there will be some limitations because of residual motor or sensory deficit but seldom something which can not be tackled. Of course we hoe for the best. Because we hope that further episode will not occur for we have covered all the bases or risk factors. About honest reply about dementia. If epidsodes keep on occuring yes dementia can occur but that is what we are preventing by all this treatment and preventive measures. We can certainly hope that we will prevent further episodes and halt the progression of disease

If there is any further query I will be most ahappy to answer, please ask followup question. Regards

With Best Wishes
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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