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Brain MRI-small vessel brain disease & understanding findings

Posted by sarah371 @sarah371, Jan 19, 2024

Hello,

My recent brain MRI indicates 'moderate likely small vessel ischemic changes and moderate hyperintense T2/Flair signal of the corona radiata bilaterally'.

Do these findings possibly indicate small vessel brain disease that may be similar to my previously diagnosed coronary microvascular disease?

Thank you.

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1427donwood | @1427donwood | Aug 21 2:26pm

Can one symptom be Auditory Hallucinations?
That's what I am experiencing.

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Maryann | @mkoch | Aug 21 2:48pm
In reply to @keithl56 "@hocbc There is no treatment for microvascular ischemia. My neurologist told me "I can't roto root..." + (show)
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@hocbc
There is no treatment for microvascular ischemia. My neurologist told me "I can't roto root your brain". Unfortunately, all you can do is try to manage the symptoms the best you can. Symptoms depend on what part of the brain has reduced blood flow.

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@keithl56: An MRI scan from UCSF notated that I have "chronic small vessel ischemic disease." I just checked AI and it is stated that is the same as microvascular ischemia. I saw a neurologist last week to ask about this condition. First of all, he reviewed my CT with me and said it is typical for someone my age, 74. He said the number one factor causing this condition is high blood pressure and asked if mine was under control--control being the top number under 130 and the bottom 80 or below. I never had high blood pressure till after chemotherapy 7 years ago. For some reason my P.C.P. didn't put me on b/p meds until 2 years ago all the while before then my top number was consistently in the 130s. The neurologist also mentioned other risk facts for microvascular ischemia, such as diabetes. He said there are not drugs to treat it and the number one thing I need to do to keep it stabilized is to monitor my blood pressure and exercise.

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keithl56 | @keithl56 | Aug 21 3:33pm
In reply to @mkoch "@keithl56: An MRI scan from UCSF notated that I have "chronic small vessel ischemic disease." I..." + (show)
Profile picture for Maryann @mkoch

@keithl56: An MRI scan from UCSF notated that I have "chronic small vessel ischemic disease." I just checked AI and it is stated that is the same as microvascular ischemia. I saw a neurologist last week to ask about this condition. First of all, he reviewed my CT with me and said it is typical for someone my age, 74. He said the number one factor causing this condition is high blood pressure and asked if mine was under control--control being the top number under 130 and the bottom 80 or below. I never had high blood pressure till after chemotherapy 7 years ago. For some reason my P.C.P. didn't put me on b/p meds until 2 years ago all the while before then my top number was consistently in the 130s. The neurologist also mentioned other risk facts for microvascular ischemia, such as diabetes. He said there are not drugs to treat it and the number one thing I need to do to keep it stabilized is to monitor my blood pressure and exercise.

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@mkoch

Do you also have CAD? The same mechanism causes both so you might have that issue as well. At least that is treatable.

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Helen, Volunteer Mentor | @naturegirl5 | Aug 23 11:32am
In reply to @hocbc "@naturegirl5 My primary care doctor told me that I had plaque in my brain and did..." + (show)
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@naturegirl5
My primary care doctor told me that I had plaque in my brain and did not advise me about special foods or anything, she just said that at my age 80 that it just happens. I have considered going to a neurologist.

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@hocbc Did your doctor talk with you about any of the following?

High blood pressure
Your cholesterol and triglycerides
Plaque accumulation in your large arteries in your heart

These are all topics I have discussed with my primary care provider. I am now 74 years old and as our age advances we have more cardiovascular risk for heart attacks and strokes. My LDL (bad) cholesterol has gone up as have my triglercerides. My blood pressure is in the normal range. My primary care provider ordered a heart calcium scan to examine the amount of plaque that might have accumulated in my arteries going to and from my heart.

Mayo Clinic: Coronary Calcium Scan

-- https://www.mayoclinic.org/tests-procedures/heart-scan/about/pac-20384686

The scan showed slight accumulation of plaque in one coronary (heart) artery. The others were all clear.

Since it is your heart that pumps blood to your brain it is reasonable to look at the arteries of your heart. That was my doctor's thinking.

After these blood tests and coronary calcium CT scan my doctor recommended that I take a statin. The statin will reduce the plaque that accumulates in my blood vessels including my heart and ultimately my brain.

So, I think it's reasonable to assume that any of us will have some plaque when we are in our 80's. I would think that you could work on diet and exercise - you could ask your doctor to refer you to a nutritionist to help you make dietary changes that are healthy for you. You could also talk with your doctor about exercise recommendations. You could also ask for a referral to a neurologist.

What do you think you might do next?

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