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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do white spots in the brain indicate after a stroke?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 7096 Questions

Posted on Fri, 24 Nov 2017 in Hypertension and Heart Disease
Question: I have had 2 small strokes 1, 2014Nov. 1 May 2015. MRI 2010 showed a white spot on my brain with no answer or solution. Corradas are more than 50% blocked, taking Atorvastatin 20 mg, Having pretty severe equilibrium problems. If I stand up too quickly or turn my upper body too quickly I become disorientated and off balance. Have had Mitral valve replacement with a pig valve July 3,2015. Cardio says heart very strong and murmer is gone. 2016 May diagnosed with colon rectal cancer at stage 3. Endured rediation treatments and chemo. then surgery. then much more chemo. Lost 10 inches of colon and a few inches of colon at anal attachment. Now pet scan shows Cancer free after 14 months of hell. Strokes were in part of brain that controls sensation and feeling. No residuals from strokes other than a little numbness in my left cheek and lips. The white spot on my brain has never been explained. Been to 4 Neurologists all very good at their profession.
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:

Thank you for asking on HCM!

Regarding your concern, I would explain that the white spot is related to the old stroke.

It doesn't change in time.

I would just recommend taking daily aspirin 80 mg, if no contraindications.

Regarding the lightheadedness, I recommend performing a Head Up Tilt test for postural hypotension.

Hope to have been helpful!

Kind regards,

Above answer was peer-reviewed by : Dr. Raju A.T
Follow up: Dr. Ilir Sharka 29 hours later
Yes very enlightening. I went to my primary doctor yesterday as well and they have now founf that my blood pressure is low. I have not taken my Lasinopril in 2 months. But have to take the Metoprolol for the blood pressure in my heart after the open heart surgery. the diagnosis of the whit spot may very well be true as I remember an incident concerning getting up out of a chair and having felt like I was hit by lightning where my frontal lobes would be situated. On top of that area, knocked me down and I had the chills after that. That was in 1980. Wow I may have had a stroke way back then. I was 32. Thank you so much doctor, We have added another chapter to my medical history. Will pass info on to my Neurologist and my Primary. Good stuff to know. Health First here in Brevard County, Florida has a data base on me which I will have this added. Nobody knew, least of all me.
Answered by Dr. Ilir Sharka 5 minutes later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I know that it may sound strange, but you should know that small strokes (which seem like white spots on the brain MRI), may also occur without any clinical symptoms (called asymptomatic).

So, we can not precise the time of their occurrence.

The fact that you have narrowed carotid arteries, imposes you to a higher risk for further brain strokes.

That is why it is necessary to take blood thinners and statins (if you have dyslipidemia).

Regarding MS, I would explain that a single white spot on the brain, at your age would be very exceptional for MS. So, in my opinion, you should exclude this possibility.

Regarding dizziness and gait balances, they could be related to the chemo that you have performed. But, I recommend performing a Head Up Tilt test to investigate for orthostatic hypotension.

Hope you will find this answer helpful!

Best wishes,

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

The User accepted the expert's answer

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