Hello Thanks for writing to HCM Small old ischaemic lesions in the subcortical white matter in the left frontal lobe is due to involvement of small blood vessels. Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia. So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus so that further progression of disease can be halted. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. Proper treatment depend upon findings. You are also suffering from degenerative disc disease of cervical spine. Degenerative changes occurs in spine due to aging and development of weakness in annulus fibrosis. 1.There is dessication of disc(loss of water) with postero-central disc bulge at C6-7 level. Majority of the cases of degenerative spine disease are benefited by physiotherapy,so physiotherapy should be tried first. Surgery should be the last option. There are also medicines like capsule pregabalin available for pain relief. Treatment can be planned after consultation with neurologist. Hope i have answered your query. Take Care Dr.Indu Bhushan