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What is white matter ischaemia and cerebral atrophy ?

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what is low density periventricular changes, in keeping with longstanding white matter ischaemia and cerebral trophy? This is part of the diagnosis of my husband's Vascular Dementia. On an ECG it showed 3rd degree AV block and complete left bundle branchblock, not having medication specially for this only two blood pressure tablets, the consultant said his vascular dementia was caused by undetected blood pressure. My husband says they have it all wrong and that his heart is good. I would like to know just to be able to monitor what he does. Thanks.
Posted Fri, 20 Apr 2012 in Alzheimer's
Answered by Dr. Rakhi Tayal 35 minutes later
Hello Mavis.

Thanks for your query.

The low density periventricular changes seen on MRI refers to slow and gradual ischaemic changes in the white matter of the brain. They occur due to various factors including high blood pressure. This and the atrophied cerebrum are seen in dementia. It is slow or chronic stroke like process occurring in the small areas of brain around the ventricles of the brain.

His ECG is showing a third degree AV block with left bundle branch block. This means electrical stimulations of heart which are responsible for contractions of heart are not getting transmitted to one half of the heart. Third degree AV blocks need artificial pace maker. He might need it.

You want to consult a cardiologist and follow thier advice strictly in order to restore normal heart functioning. Blood pressure, heart issues needs to be adressed to prevent dementia changes from worsening.

Hope I have answered your query. I will be available if you have any further queries.


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Follow-up: What is white matter ischaemia and cerebral atrophy ? 3 hours later
Dear Dr. Tayal,

Thank you very much for your explanation of the brain and ECG query.

Regarding the ECG in July 2010 the Cardiologist's report gave diagnosis as LBBB and 1st degree heart block with Memory Service Consultant's report showed a 3rd degree AV block not 1st as before. How different is 3rd degree from 1st?

In general he is a fit man, has always exercised and run regularly, although now only goes out for walks and short rides on his bike close to the house.

Again thank you so much for your time.


Answered by Dr. Rakhi Tayal 1 hour later
Hello Mavis.

Thanks for writing back.

First degree heart block is due to delay in transmission of electrical impulse from atria to ventricles of the heart but each and every impulse is transmitted and normal contraction of heart continues.

Third degree heart block means that the impulses from atria are not getting transmitted to the ventricles and both of them are not beating in a synchronised way and the blood is not properly pumped out from the heart with every beat.

In such cases an external pace maker is implanted which produces its own impulses and heart starts functioning in a synchronized way.

Hope I have answered your query. I will be available if you have any further queries.
Wish you an early recovery.
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