Hello Thanks for writing to HCM Nonspecific white matter signal abnormality are mainly due to chronic microvascular ischemic changes resulting from involvement of small blood vessels. Iischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia. So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. There is also a vein which is in contact with proximal left trigeminal nerve near the trigeminal nerve root entry zone.This is incidental finding and doesn t require any treatment. Hope i have answered your query. Take Care Dr.Indu Bhushan