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What causes chronic microvascular ischemic disease?

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Posted on Tue, 1 Sep 2015
Question: What is chronic microvascular ischemic disease of my brain and how does this differ from my previous diagnosis of multiple sclerosis?
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Answered by Dr. Olsi Taka (54 minutes later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern. To be told a different diagnosis after 20 years mist be really disconcerting.

Chronic microvascular changes means narrowing of the small blood vessels, the most distal ones in the circulation tree, the ones with the smallest caliber. As a result the small areas which they supply are damaged from the lack of blood flow in them. Usually these changes are diffuse, so small diffuse brain lesions are noted which in your case were mistaken for MS which also causes small multiple lesions.
Some vascular changes are common with age to a degree, but appearing already at 45 (since you say 20 years) is uncommon, usually later.
Usually they are related apart from genetic factors to conditions affecting blood vessels like high blood pressure, diabetes, smoking. If no such factors are present other rarer causes such as amyloidosis, connective tissue disease must be considered. At times no cause is found.

Whether an earlier diagnosis would change something, in terms of vessel disease would make you more aware to the need to address hypertension, smoking etc. But there is no specific treatment you missed, only some aspirin as blood thinner.
Also wouldn't take unnecessary MS treatment naturally.

I remain at your disposal for further questions.

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

Neurologist

Practicing since :2004

Answered : 3667 Questions

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What causes chronic microvascular ischemic disease?

Brief Answer: Read below. Detailed Answer: I read your question carefully and I understand your concern. To be told a different diagnosis after 20 years mist be really disconcerting. Chronic microvascular changes means narrowing of the small blood vessels, the most distal ones in the circulation tree, the ones with the smallest caliber. As a result the small areas which they supply are damaged from the lack of blood flow in them. Usually these changes are diffuse, so small diffuse brain lesions are noted which in your case were mistaken for MS which also causes small multiple lesions. Some vascular changes are common with age to a degree, but appearing already at 45 (since you say 20 years) is uncommon, usually later. Usually they are related apart from genetic factors to conditions affecting blood vessels like high blood pressure, diabetes, smoking. If no such factors are present other rarer causes such as amyloidosis, connective tissue disease must be considered. At times no cause is found. Whether an earlier diagnosis would change something, in terms of vessel disease would make you more aware to the need to address hypertension, smoking etc. But there is no specific treatment you missed, only some aspirin as blood thinner. Also wouldn't take unnecessary MS treatment naturally. I remain at your disposal for further questions.