Chronic small vessel ischemic disease

I had sudden onset of dysarthria in December 2024. Initially, it was mild but has gotten worse and I now have severe weakness of my right arm and hand.
My diagnosis is small vessel disease of the brain. I am learning that brain cells can regenerate and I want to find someone who can assess and treat. I’m a young 72 and I want to turn this around. Was reading and watching lectures by Lewis Clarke, MD, PhD, in Webster, TX. He’s on You Tube and he discusses cell regeneration. Previously, I was told I had the best insurance. This year, suddenly no one will take my insurance. I’m assuming small vessel disease of the brain is the cause. Age is just a number; my grandmother, at 82, was the most vibrant and intelligent ladies I ever knew. Age should not be a factor in receiving the best medical treatment and Health Insurance Companies should not prevent us from receiving treatment. I plan on getting well despite the obstacles placed in my/our way. Prayers! GOD is over every CEO🙏🏽✝️

Hi, @toddmiller1963 - tagging a few members who may relate to your situation with your mother diagnosed with small vessel ischemic disease @niquinon @venki @bosworth @molugu @rubytue70 @sally12345 @caregiver49. Hoping they can relate to how sudden and profound her memory issues have been, including her ability to make new memories.

Is she still without treatment for this disease at this time, toddmiller1963? Is anything coming back from the last 10 years?

My husband age 71, was diagnosed with small vessel disease. His doctor thinks it was brought on by sleep apnea. He uses a clap now.
As far as building new brain connections.... I've had MS for 30 years. My research says that new cells, new nerve pathways are built when we learn knew things. They are also created when we do simple things a new way. Put you mouse, fork, pen, and coffee cup in your "other" hand. This grows new nerves which was described to me like building a new road to the same old destination. Also learn to do a new thing with 2 hands. Knitting and crocheting are a good choice. We can make new brain pathways.

@lisalucier My apologies. I just now saw your response. She is still without any treatment. Her longer term memories come and go. I'd say there has been no change there. The biggest problem to functioning is she just can't make new memories at all.

@toddmiller1963

I've been diagnosed with "cerebral small vessel disease" and am 80. The neurologist has never explained the specifics of my MRI brain scan, but two doctors who have casually viewed/reviewed the scan say some of that is normal by my age -- and your mother's. Mine is cardio-related -- inadequate blood flood to the brain intermittently and briefly.

I do know this much: It's a risk factors for vascular dementia, and that kind affects mobility (so balance) and "executive function" -- analyzing, thinking, planning. It can move fast. Memory is typically NOT as primary a concern as it is with Alzheimer's.

I suggest you try to get a referral ASAP to a neuropsychologist and a university. They specialize in this diagnosis.

@sandy8043 Your statement is partially correct. We do not generate new neurons, but neuronal tissue forms new connections with adjacent neurons. This is neuroplasticity, which helps patients recover from a stroke. Small vessel ischemic changes are irreversible, but high dose statins are often prescribed to help slow progression. Talk to your doctors and determine if a statin is best for you.

What is the treatment or therapy you are undergoing now? My husband (age 76) has stumped all the ophthalmologic neurological specialists and all the other neurologists at Kaiser, because he has had this condition ever since his heart surgery in 2022, with spells of temporary blindness (amaurosis fugax), ocular auras and dizziness, along with 2 small lacunar strokes, and all the recommendations they have are is "diet and exercise." He is an athlete who bicycles, works out, does tons of yard work and eats a low carb diet. Can't get more healthy than that. He is on Pradaxa blood thinner, to hopefully guard against a major stroke, but meanwhile the Sword of Damocles hangs over his head, and all they can say is - "beats me." Who can he see next out of Kaiser network who won't tell him the same thing?

I know this is an older thread, but I just got MRI results showing this and I am only 39 and unsure of whats to come. I don’t know if anyone in these threads are under 40? Online says it’s uncommon. Thank you.

@knoxville25 Wondering how you are doing? I’m 71 with WMH showing up on a brain MRI, so seriously concerned about managing this.

Thought you might be interested in what AI came up with, some very current info:

Repurposed Medications (The Frontier of CSVD Care)

The most significant pharmacological breakthrough for chronic small vessel disease comes from the LACI-2 trial (Lacunar Intervention Trial-2), with long-term data published and reviewed through 2024–2025 (Blair et al., 2024).
Because CSVD is driven by endothelial dysfunction, blood-brain barrier leakage, and impaired nitric oxide signaling, researchers successfully tested two repurposed medications (Bath, 2025; Jin, 2026):
Isosorbide Mononitrate (ISMN): A nitric oxide donor that improves blood vessel dilation and reduces systemic vascular resistance (Bath, 2025; Yılmaz, 2022).
Cilostazol: A phosphodiesterase-3 (PDE3) inhibitor used traditionally for peripheral artery disease that acts as a vasodilator and prevents harmful platelet clumping (Bath, 2025).

The Evidence
The LACI-2 trial revealed that patients taking Isosorbide Mononitrate and Cilostazol in combination experienced a dramatic reduction in vascular, cognitive, and functional dependency events (Bath, 2025). Remarkably, improvements in executive cognition, mood stabilization, and overall daily functioning were observed within just 6 months of initiating therapy (Bath, 2025). While larger Phase III trials are ongoing to make this standard global practice, it is currently the strongest proof-of-concept for direct medical intervention (Jin, 2026).

The AI response also mentioned controlling metabolic health and high blood pressure.