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MRI shows scattered deep white matter which is seen in microvascular ischemic disease. Having headaches, dizziness. Suggestions?

MRI with/without contrast showed Scattered deep white matter T2/FLAIR hyperintensities noted, non-specific- most commonly seen with chronic microvascular ischemic disease. This is the only part of the report I have access to at present. I am an overweight (please don t say this is the cause), 50+ y/o female with a history of diabetes (that is food intake controlled and six months+ reports show levels within normal limits), high blood pressure (taking bp and fluid meds which dr has recently doubled both but bp is still 136/90), and high cholesterol (cardiologist stated this was genetics ). Before meds were doubled, I have been having continuous headaches for more than 3 weeks (from throbbing to severe in intensity) only on left side--at base of skull , in front of ear and behind eye. Dr. left a voice mail that everything looks normal on MRI. My head still hurts, I m missing work, getting dizzy (not falling, but I feel it coming on and brace myself). Please advise/suggest a next step for me.
Asked On : Tue, 26 Feb 2013
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Neurologist 's  Response

Thanks for the query,

Please note that MRI findings should be interpreted along with the clinical data. The MRI data that you have provided could seen in patients with diabetes, hypertension. These changes reflect micro vascular ischemia. You donot have to worry for this changes at all.
Back to your headache. Headache can be due to various causes like migraine, cluster headache, tension headache, infection in the brain, brain tumor and so on. The possibility in your case could be migraine and/or tension headache. These diagnoses are that of exclusion. Further if the headache duration is only of 3 weeks, other conditions must be excluded before securing the diagnosis of migraine. Good that your MRI is normal. I advise you to get a neurological evaluation done by a neurologist. He will then determine a lumbar puncture will be required in your case or/not.
Management will be as per the cause

Hope this clarifies your query

Best wishes
Answered: Thu, 28 Feb 2013
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