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What does Mild-moderate small vessel micro-ischemic changes of the white matter of cerebral hemisphere mean?

May 2014
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Practicing since : 2002
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what does Mild-moderate small vessel micro-ischemic changes of the white matter of the cerebral hemispheres mean?
Posted Tue, 15 Oct 2013 in Brain and Spine
Answered by Dr. Vivek Chail 1 hour later
Brief Answer:
Please find detailed answer as given below

Detailed Answer:
Thanks for writing in to us.

I have read through your query in detail. The clinical problems related to the brain condition are most likely diabetes and hypertension in association with raised cholesterol numbers.

The MRI findings are explained below in simple language. MRI brain was done to investigate vertigo as documented in the report.

1. The ventricles and cortical sulci are slightly prominent. This is consistent with mild atrophy.

This explains that the surface impressions over the brain (sulci and gyri) are slightly prominent or well demarcated. This can be expected in a 65 years old and due to age related developments. The fluid containing spaces (brain ventricles) are also slightly prominent and this too is an age related development.

2. Small vessel micro-ischemic changes involve the white matter of the cerebral hemispheres to a mild-moderate degree as well. No acute diffusion restriction or acute infarcts are reported. No hemorrhage is seen.

There are large arteries which subsequently branch into smaller arteries and vessels to supply the entire brain. It is mentioned that there is micro -ischemic (microangiopathic) change which can be best described as very small areas where due to slightly abnormal blood supply, there is injury to the nerve cells. Our brain contains billions of nerve cells and in your situation just a few are involved and you must not worry about it. Vertigo can be caused due to micro ischemic changes. Damage also depends on the location and in your MRI it is not a very important region that is involved.

The commonest causes are aging, diabetes, raised cholesterol and high blood pressure. This does not indicate that there was any acute stroke earlier but there could have been small XXXXXXX strokes. However you must control your diabetes, blood pressure and cholesterol so that complete strokes are not manifested. At the same time please keep your mind free from any kind of mental stress.

I would recommend you to get completely examined by your neurologist and follow a healthy diet and good fitness plan. Do not exert yourself and try to lead a stress free life that is normal in every way. Report to your doctor if you experience any neurological symptoms like dizziness, twitching, jerks, fits, numbness, tingling, visual and speech problems to name a few.

Hope your query is answered.
Do write back in case of doubts.

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