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Dr. Andrew Rynne

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What Is The Cause For Numerous Small Foci Present In The Cerebral Hemispheric White Matter With Irregular Heart Beats?

I just had an MRI due to having migraines for a week - not like me. I am 67 years old, but am diabetic from an acute case of pancreatitis, take high blood pressure pills and cholestral meds. My blood work was good low blood pressure from meds. My MRI said:

"Brain parenchyma: Numerous small foci and some patchy confluent areas of hyperintense T2/FLAIR signal are present thout the cerebral hemispheric white matter with relative sparing of the temporal lobes and infratentorial brain panchenchyma in a pattern most consistent with chronic microvascular ischemia. There has been significant interval increase in the number of these lesions since the previous examination (which was years ago when they increased my blood pressure meds). The brain parenchyma is otherwise grossly unremarkable. There is no abnormal parenchymal enhancement. Hemorrhage: There is no evidence of intraparenchymal or extra-axial hemorrhage. Ventricles: Ventricles, sulci and cisterns are normal for age without evident of mass effect or shift. Herniation: None.
What is going on and what would be treatment of this? My father died of a heart attack at 72 years of age, but my mother lived til she was 94. Could this be a problem with my heart? I have an irregular heart beat like both my parents. I am a retired teacher, but still substitute often. My brother (an opthemalogist) in his 50's just had open heart surgery to replace a valve.
Mon, 27 Jan 2014
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Neurologist 's  Response
Hi,

Thank you for posting your query.

I have noted your symptoms and the MRI brain findings.

These small foci of hyperintese lesions are due to ischemia (lack of blood flow to brain). The underlying risk factors for these lesions in your case are blood sugar, high BP and cholesterol. If your heart rhythm abnormality is due to atrial fibrillation, then, that could also be a risk factor.

These lesions indicate a higher risk of stroke in you, which can lead to paralysis. So, I would advise you to be on aspirin tablets to prevent stroke in future.

In addition, your risk factors as mentioned above should be kept under good control.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

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What Is The Cause For Numerous Small Foci Present In The Cerebral Hemispheric White Matter With Irregular Heart Beats?

Hi, Thank you for posting your query. I have noted your symptoms and the MRI brain findings. These small foci of hyperintese lesions are due to ischemia (lack of blood flow to brain). The underlying risk factors for these lesions in your case are blood sugar, high BP and cholesterol. If your heart rhythm abnormality is due to atrial fibrillation, then, that could also be a risk factor. These lesions indicate a higher risk of stroke in you, which can lead to paralysis. So, I would advise you to be on aspirin tablets to prevent stroke in future. In addition, your risk factors as mentioned above should be kept under good control. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in