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What does this MRI report indicate?

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Practicing since : 2004
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I recently had a MRI of which I havea ttached the report My neurologist only gave me a few minutes of her time to discuss the results and then gave me a referral to a cardiologist for a consultation. The reason for the consultation was indicated as "heavy amount of microvascular disease, please assess cardiac". I have an appointment with a cardiologist on Dec. 19, 2017. The reason for my health question is that I would like a better understanding in layman's terms of the attached report of my MRI. As stated above, my neurologist only gave me a very quick assessment which left me somewhat demoralized after leaving her office.
Fri, 27 Apr 2018 in Headache and Migraines
Answered by Dr. Olsi Taka 40 minutes later
Brief Answer:
Explanation as follows....

Detailed Answer:
I read your question carefully and I understand your concern.

Reading that report I would say that the use of the term "heavy" is not correct. The report says only moderate, it doesn't speak of severe changes.

Regarding their significance, they are due to changes in the walls of the blood vessels which may lead to closure of the tiniest of these vessels, the ones of the smallest caliber. As a result there are small areas of damage in the areas supplied by these blood vessels. Individually as these are minuscule areas they do not cause any noticeable consequences, but when there are many such areas the lost tissue sums up to significant amounts and may cause changes such as slowing of movement and higher mental functions. So the significance depends on the degree, whether mild, moderate or severe.

To a point they are part of aging, the older we get the more likely it is for MRIs to evidence such changes. In your case though for your age of 60 having moderate changes is premature, worse than average, so they should be evaluated and if possible some measures must be taken to slow down their increase. Partially it is due to genetic factors for which not much can be done, but some factors may affect and accelerate the appearance of such changes. Such factors are conditions which affect blood vessels such as high blood pressure, diabetes, smoking, high cholesterol etc. For that reason you've been referred to a cardiologist to screen for such risk factors.

I remain at your disposal for other questions.
Above answer was peer-reviewed by
Follow-up: What does this MRI report indicate? 22 hours later
Dear Dr. Taka,

Thank you for your detailed answer. You provided me with more information than my own neurologist. I would like to add some follow up questions. Is Plavix the best medication that I should be on considering the results of the MRI report? What lifestyle changes do you suggest I make to ensure my brain health as I get older? Please note that I do not have high blood pressure or diabetes. I quit smoking over 5 years ago. I do not drink alcohol. I go on 30 – 40 minutes walks during lunch hour at work Monday to Friday and try to take walks on the weekend. I do one hour a week of yoga. I limit my intake of sodium as much as possible. I take 2 x omega3 capsules, 3 x vitamin D3 tablets and a B12 vitamin tablet daily. I eat a good diet with plenty of vegetables. I very rarely eat red meat or processed food. Any other suggestions that you may recommend would be greatly appreciated.
Answered by Dr. Olsi Taka 2 hours later
Brief Answer:
Read below

Detailed Answer:
Thank you for the feedback.

Regarding the question about Plavix, yes antiaggregant medication like Plavix are what is recommended. Usually Aspirin is the first choice as it's cheaper, in terms of efficacy Plavix is just as good.

As for seem to already be aware of the necessary steps, the list of precautions you employ includes pretty much all that I would advise. Some more physical activity, possibly some light jogging would be even better.
Vitamin B6 and folic acid may be added to vitamin B12 as well. But really in general you seem to be doing all you can, there isn't any supplement of significant additional benefit I would add.

Let me know if I can further assist you.
Above answer was peer-reviewed by
Follow-up: What does this MRI report indicate? 21 hours later
Thank you Dr. Taka, your feedback is much appreciated.
Answered by Dr. Olsi Taka 2 minutes later
Brief Answer:
You're welcome.

Detailed Answer:
Wishing you good health.
Above answer was peer-reviewed by
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