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Stroke

Effects of white matter disease

04/30/2008

Question:

I am a 40 yeard old female and after some neurological issues, I had a MRI of the brain. Listed are the results:

"FLAIR imaging sequence demonstrates two focal abnormal bright intensity foci in the subcortical white matter of the left frontal lobe and about four to five subcortical bright intensity foci in the left parietal white matter. A single lesion is seen in the right parietal subcortical white matter. These are most likely due to chronic small vessel disease and ischemic changes. Post contrast examination demonstrates no evidence of abnormal enhancement, edema or mass effect."

After reading all the helpful information on your site, I have a couple of questions. Is this something that should be followed up on at a later date, possibly another MRI in 6 months or so (I do not have high blood pressure or diabetes but I do suffer from headaches)? I know these abnormal areas can be caused by many things, does it basically mean that no matter what the cause, the end result is damage to the nerves in the brain? What kind of long term concerns will these abnormal areas cause? If the cause of mine is from my headaches, is that what could be causing my neurological concerns?

Thank you so much for your time, it is greatly appreciated.

Answer:

White matter changes on MRI are extremely common especially in elderly patients with a history of hypertension. Migraine headache is also known to cause similar changes. In your case, it is also probably benign. However, because you are young I would recommend consultation by a neurologist to confirm it is a benign process and exclude other concerning etiologies such as multiple sclerosis and vasculitis (inflammation in the blood vessels). Regards.

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Response by:

Yousef  Mohammad, MD, MSc Yousef Mohammad, MD, MSc
Assistant Professor
Director, Stroke Fellowship Program
College of Medicine
The Ohio State University