Chronic Microvascular Ischemic Disease

Dr. Scott Speelziek, M.D. ( The good Dr. is a very pleasant person) No evidence of acute infarct or new significant changes in small-vessel disease. Not sure if this is good or bad news?

"He does have hyperreflexia most notable at the bilateral patella where there are crossed adductor signs and +2 reflexes bilaterally. In the upper extremities, I would grade his reflexes at +2 on the left and +1 on the right negative Hoffmann sign"

The exam is suggestive of perhaps a spinal cord pathology in the low cervical or upper thoracic spinal cord.
My hyperreflexia as well as evolving paresthesias or numbness and balance issues would raise a suspicion for pathology there either in terms of intrinsic cord inflammation, which is relative
An MRI of the cervical spine. to evaluate for any potential pathology involving the cervical spine. additional testing including potentially EMG could be pursued.
As far as the Mayo Clinic Tapestry Study people are randomly offered to ask to participate. The good Dr. said felt like it was more of a business decision with help from Helix genomics company to compete with 23andMe and other DNA test kit companies.

I understand JanaShay 13 as I have cardiac microvascular disease. Very common in women. I have been dealing with this for 10 years now since age 58. I take medication for chronic angina. Unfortunately my cardiologist informed me this condition is "systemic"...I wouldn't be surprised if I too had it in my brain. I had a concussion in 2019 and still feeling the effects - one of which is forgetfulness, migraines or saying the wrong word (as soon as I say it, I do know it). However MRIs of my brain showed a "normal" brain in 2020 (last one). Try not to despair and, hopefully, there are medications targeted for the brain. Be sure to see an excellent neurologist.
Johns Hopkins in Baltimore, MD is number 1 in the country for neurology. Perhaps a trip there would be beneficial for another opinion. Check out 2023 US News and World Report for their hospital rankings according to specialties there may be a closer location for you. In the meantime I hope you are doing everything you can to lower your stress level...yoga, meditation, walking, music, gratitude journal, spirituality as you define it, healthy eating, aromatherapy, spa treatments...find whatever works for you, these are only examples.
The very best of luck to you!

Overall I would view this as good news. No acute infarct means no evidence of a stroke, and no new changes in the SVD means that it isn't progressing significantly. I also have chronic micro vascular disease and can empathize with you.

I think that the normal for reflexes is +2, and a negative Hoffman sign is also good.

An MRI is a painless way to see if you have any nerve compression that could cause your paresthesia.. It could be something as simple as a pinched nerve or slipped disc. I have had both cervical and lumbar fusions (and a lumbar discectomy) due to injuries. The cervical surgery was not that bad and if necessary don't worry about it. I have had 2 EMG's due to ulnar nerve damage and they are not fun.

Just follow your doctor's recommendations. If your symptoms are an issue you can choose to have further testing to see if there is a course of action that you may benefit from.

Good luck!

I have diabetes and have been diagnosed with micro vascular ischemia. Noticed my balance is off, feel light headed and vision has worsened, especially in the dark. Is this part of the illness?

I assume that you are referring to ischemia in your brain (white matter disease). I have the same thing. Balance is definitely a possible symptom, as it is in my case. Sometimes I am wobbly (my wife's technical term!) and light headed and as a result have had a couple of falls. My wife won't let me on a ladder without supervision. As far as vision, I have noticed a similar degradation but can't distinguish if it is from the ischemia or the normal aging process.

At my last neurologist appointment as he put me through the normal tests I joked that I hope that the police don't pull me over for anything because I wouldn't be able to pass the field sobriety tests even if I haven't had a drink for a week!

Good luck and hope that your disease progresses slowly.

Keith

Keith

Thank-you for confirming what diagnosis from my recent MRI. For 30 years I have been a diabetic, I am 71 now. No Dr or neurologist told me that diabetes could damage your brain getting Microvascular Inshemnia. Why is this not made more public that this can happen with high glucose and blood pressure??

In most people that have cerebral microvascular ischemia the cause is plaque build-up, the same as cardio vascular disease (as in my case). I'm not sure about the relationship with diabetes or blood pressure. You really can't treat it but a healthy life style may slow progression. Mine seems to have slowed down (maybe wishful thinking!)

Keith

What medication are you taking for it?

I am taking ramiphil, rosuvastain calcium, trrsiba and novolog

I take rosuvastatin and zetia to slow/stabilize the plaque buildup and aspirin to thin the blood.