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Global brain atrophy, Hepatitis c - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hello, I have been told that I have global brain atrophy, moderate to severe chronic microvascular disease, and an infarct in right temporal lobe. I have Hepatitis c, for 40 years, am waiting for new drug, Teleprevir . I was treated 10 years ago with interferon & ribaviran and relapsed. Any advice?
Doctor :   Hi
Doctor :   May I know your age and gender?
User :   Hello
Doctor :   Can you describe your symptoms?
User :   Yes, 60yo, female...have had cognitive decline through my 50s. Poor sleighing memory. Attention deficit and severe spatial impairments and scored in bottom percentile for visual memory and slow processing speed.
Doctor :   Are you there?
User :   Yes
Doctor :   Ok
Doctor :   Are you been diagnosed to have vasculitis?
Doctor :   Do you have diabetes?
User :   OK I meant "working memory
User :   No diabetes, or other typical risk factors
Doctor :   Ok
Doctor :   let me explain to you.
User :   The word vasculitis has not been mentioned
Doctor :   Brain atrophy is explained by microvascular abnormality.
Doctor :   However, there are few risk factors that can induce microvascular disease
Doctor :   which also needs evaluation.
Doctor :   Yes, age being one such factor.
Doctor :   however a severe atrophy at an age of 60 is not explained by age alone.
User :   Thats what I hear
Doctor :   Risk factors such as diabetes, high cholesterol or presence of any autoimmune conditions such as vasculitis presence needs to be assessed.
User :   Doc says my brain looks like much older persom
Doctor :   Hence you need to consult a neurologist who will perform few investigations which will include blood counts, vitamin B12 levels. blood sugars, metabolic and endocrine parameters, and vasculitic work up.
Doctor :   multivitamin supplements,
User :   My cholesterol is great...good ratios
Doctor :   Treatment will be based on treating the cause if any,
Doctor :   blood thinning medications, multivitamin pills
User :   Hep c is likely cause??
Doctor :   and cognitive training based on the deficiets you have.
Doctor :   Hepatitis C is not known to cause brain atrophy and microvascular disease.
Doctor :   The infection is more localised to the liver.
User :   I'm on multiple vitamins omega 3-6-9
Doctor :   Brain damage is seen when there is a significant liver damage which leads to hepatic encephalopathy.
Doctor :   There again, scans usually show edema more than atrophy.
User :   Maybe I'm there
Doctor :   Hence, I do not consider Hep C infection responsible for the brain atrophy.
Doctor :   Have you followed?
Doctor :   Continue on multivitamin and omega supplements.
User :   Research has found that virus has been found infecting brain. Gets by bbb
Doctor :   Discuss with your neurologist who after the investigation will be able to provide you with more information.
User :   Ok
Doctor :   The brain atrophy that you is seen is because of ischemic changes secondary to microvascular disease
Doctor :   and very unlikely due to Hep C infection alone.
Doctor :   Have you followed?
User :   It's feasible that it is combination, right?
Doctor :   More due to microvascular disease.
Doctor :   If there is a contribution by the infection,

Doctor :   that will be an insignificant one.
Doctor :   Have you followed?
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