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What is chronic microvascular angiopathy?

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Practicing since : 1988
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I had an MRI of my head and one of the findings was chronic microvascular angiopathy. I am a 74 year old female, no diabetes but do have other medical problems. Should I be concerned?
Posted Wed, 6 Aug 2014 in Brain and Spine
Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
Control risk factors

Detailed Answer:
Good evening. My name is Dr. Saghafi and I would like to provide the following information to you regarding your question.

Please allow me to summarize what I know of your case. You are a 74 year old YOUNG LADY who has at least a history of the following medical problems:

RA, CLL, hypothyroidism, hypertension, COPD, neuropathy, RLS

You are not diabetic.

Your question is whether or not you should be concerned given a radiographic finding of "microvascular angiopathy." Please allow me to define in more nontechnical terms "Microvascular angiopathy."

Microvascular- Very tiny blood vessels (capillaries)
Angiopathy- deterioration seen in an organ's blood vessels ( in your case white matter of the brain)

Microvascular Angiopathy- capillary deterioration (in your case the white matter of the brain) seen as thickening and leakage from the microscopic region under consideration of fluid and proteins.

The most common reason for the presence of microvascular angiopathy seen in the brain is the aging process. Beyond age 40 there is almost always some degree of microvascular angiopathy that can be seen in individuals with even no major risk factors or medical conditions. In your particular case there are several conditions you have which do elevate your risk of developing this condition.

Microvascular angiopathy is generally a very slowly progressive condition. Should you be concerned? I think "being concerned" is tantamount to having any chance of either slowing down or halting progression of the condition. However, at the same time please realize that it is something you have had with you for years, even decades and therefore, CONCERN should not be mistaken for WORRY or LACK OF MOTIVATION to control risk your risk factors or other conditions to the best of your ability.

Your neurologist should underscore the importance of doing things to keep your blood pressure, hypothyroidism, and rheumatoid arthritis under the best control possible such as taking medications as prescribed by your doctors. COPD and neuropathy are frequently due to the effects of smoking, high cholesterol, and excessive alcohol intake and if any of these are present then, they need to be addressed. Smoking or exposure to second hand smoke must stop. Dietary measures to reduce cholesterol, increase physical activity as possible, and reduce weight as necessary (or gain weight in some circumstances) must be heeded.

And so I firmly believe that to the extent you are "concerned" to ask the question tonight you actually have more power and authority to control how this microvascular angiopathy plays out in your brain by heeding these recommendations.

I wish you all the best and would very much like to read your feedback on our interaction. In addition, I would be happy to answer more specific questions if you have any but in the event that I have satisfactorily addressed your concerns and provided you with quality information that you were seeking, would you do me the favor of CLOSING OUT THIS QUERY on your end which will help us complete your case.

All the best to you and good luck at your neurologist's appointment.

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