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    What does this lab report indicate?

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Posted on Tue, 18 Jul 2017 in Brain and Spine
Question: Can you provide on opinion on what the Impression means/
"mild nonspecific chronic microvasculat-type white matter injury"
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Answered by Dr. Olsi Taka 2 hours later
Brief Answer:
Small vessel disease.

Detailed Answer:
I read your question carefully as well as the report. Thank you for providing the full copy of the report makes things much easier.

I do not think that you needto be worried by the use of the term injury instead of disease. Looking at the entirety of the report, the description, I am pretty confident that the radiologist meant small vessel disease and didn't have any other type of lesion in mind. There are variations in the terminology used for these white matter changes, no real consensus, terms like small vessel disease, white matter hyperintensities, leukoaraiosis etc are used by different physicians to describe the same thing, so not really surprised to see yet another term used by the radiologist.

The term is used to describe changes happening to the walls of the blood vessels. As these vessel walls thicken over the years the lumen of the smallest of them can become completely occluded leading to damage of tiny areas supplied by those tiny vessels, hence the changes. In part these changes are genetically determined, are also part of aging. However they can be accelerated by vascular risk factors like high blood pressure, diabetes, smoking, high cholesterol etc. So addressing those factors (if present) is the only thing you need to do to slow down the progression of such changes. They do not cause any symptoms, are not the cause of the headache you had the MRI for, is only a concidental finding.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 1 hour later
Dr. Olsi Taka, thank you for your response. Do you think I need a Carotid Artery ultrasound? I am 56 and my blood pressure under the stress of marital separation (on the digital machine) was 133/84 today and 131/81 2 weeks ago. I exercise vigorously and consistently. For example today I did 7 three minute rounds on the heavy bag, 15 minutes of jump rope and quarter mile repeats at the following paces per mile 7:30, 6:00, 7:00 and 5:30. Am I really a candidate for BP medication? Am I really susceptible to having a stroke?
doctor
Answered by Dr. Olsi Taka 7 hours later
Brief Answer:
Read below

Detailed Answer:
Sorry for answering a little late, your question came right after I went to sleep (time differences).

A carotid ultrasound may be advisable to do as part of a general check-up, since it is a simple non invazive exam. However it is not that vital. What we look for in carotid ultrasound is atherosclerotic plaques. These plaques though are different from the changes in the wall of the small vessels I mentioned before. Their wall structure is different from the carotid vessels and the fact that such changes were found doesn't mean that there will be major changes in the carotid. So what I am trying to say is that while advisable you shouldn't be anxiously waiting for it, that MRI report doesn't increase the chances of major changes much.

As we age the possibility of developing high blood pressure increases, about half the people over the age of 50 are affected so might be that in the future you develop high blood pressure, can't be excluded. However those values you mention are not high enough to warrant treatment, they do call for attention and measurements from time to time, but not a candidate for medication. Remember also to measure blood pressure after having rested for at least 5 minutes and not having taken coffee or some other stimulant in the preceding 30 minutes.

As for being susceptible to stroke given your healthy lifestyle, if you do not smoke or have diabetes, no heart issues, I do not think you are under a significantly higher risk of stroke.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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