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Have High Cholesterol, Diabetes And Blood Pressure. Diagnosed With Microvascular Ischemic. What Should Be Done?

Posted on Sat, 28 Jul 2012

Question: I have asked questions before regarding the following. GP had MRI ran do to dizziness, falling and balance and cooridation which I had for 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. I am on a walker and learning to use cane while at home. Now that dizziness/wooziness and balance is much better will I experience that again due to this disease. I have experienced a pain on my right side of my head followed by either dizziness or a feeling of being shaken of my whole body. This only last about 30 seconds and after this I am completely fatigued. Only happened about 5 times but I worry what this could be. My GP said sever plaque most patches on my right siide. I had a hemorratic stroke 10 years ago but have done very well with that. No longer drive since stroke due to slow reflexes. Do these little episodes signify anything going on in the brain. I have had them in shower, while in kitchen, while watching TV, so do not know what causes them to come on. Any help or advice I would really appreciate it. My therapy will be done in 2 weeks. Thank yoiu

Answered by Dr. Aparna Kohli (1 hour later)

Hi,
Thanks for writing back.
These episodes that you have described could either be transient ischemic attacks ( XXXXXXX strokeswhich is usually a warning sign for a bigger , more damaging event) or they could be partial seizures . Transient ischemic attacks occur due to the blockage of the vessels that supply the brain. Partial seizures are those which will come from 1 focus in the brain. Ischemic disease ( disease where the blood supply to the brain is reduced) predisposes people to seizures as well.
The only way to know is to do an EEG ( electroencephalogram) and a MRI ( diffusion weighted MRI) as well.
This can help us distinguish between these 2 events.
In any case, you should not be ignoring them and should be seeing your general physician as soon as possible.
Let me know if I can address any more concerns.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aparna Kohli (2 hours later)

Thank you for your quick and informative answer to my inquiry. I have visited with my GP regarding these unusual quick pain on right side but to be honest I feel he is basically brushing me off. As he told me there is nothing to reverse the damage already done but I could slow down progression by getting other problems I have under control. He told me after I finish physical therapy to go and enjoy doing whatever I feel I can that I am doing great. I sometimes think maybe he made the wrong dignose and that I do not have Microvascular Ishemic disease or am I kidding myself as he said the MRI with contrast gave that diagnose. While in hospital, he explained to my daughter and I it was serious and I would need walker rest of my life. Now in office visit, he acts like I am completely well. Even told me I could use walker if I thought I needed it or not to use it when I felt stable. I am confused as to his reactions or am I just not getting what he is saying. My head feels heavy all the time, I am sure that sounds crazy to you. If you have any advice I would appreciate it. I am also fatigued wondered if I am just depressed or does fatigue go with this disease? Thank you

Answered by Dr. Aparna Kohli (5 hours later)

Hi,
Thanks for writing back.
Your symptoms dont sound crazy to me but I can tell you one thing for sure. Its not related to your disease and are probably just due to feeling low/depression. Walking around a bit, doing things you enjoy is extremely important for each one of us and there is no reason why it should be any different for you. This will help you feel better significantly.
If you think your GP's brushing you aside, you can consult a neurologist as well. We would rather be sure than sorry later.
Also, please do firmly believe that things will get better and you're doing better than before. Even the latest research shows that such a though process can have a tremendous positive impact on your healing.
Hope this helps.
Let me know if I can provide any more information
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar