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My Father's Declining Health
Hello, my 64-year-old father had a brain MRI and one of the impressions was/is "Suspect minimal chronic small vessel ischemic disease in the cerebral hemisphere white matter."  Can someone please help me to understand what this means? The other two impressions from the MRI are as follows:
1) No evidence of acute intracranial process such as hemorrhage, acute ischemia or hydrocephalus;
2) Diffuse volume loss which appears somewhat pronounced for age.

My father has lost his ability to speak coherently. He has trouble swallowing. He has a persistent tremor in his right hand. He has lost 30 pounds in the last six months because he forgets to eat. He can't remember important dates (like when his son was born, when he got married, etc.). He can no longer do simple arithmetic (7 minus 2 baffled him, even when my mother and I showed him how to count on his fingers). And it takes him 3-4 days to do a simple word search puzzle. He doesn't understand simple instructions (like "swallow" or "close your mouth"). He has lost control of his bladder, and when he does have accidents, he doesn't tell my mother or me, he just throws his soiled clothes on the floor and when they're discovered, the floor then needs to be shampooed.

He says he's not depressed, anxious or suicidal. Stroke, Alzheimer's, cancer and an infection have all been ruled out.  He is still undergoing tests: a psychiatric test is scheduled for next week and we're waiting for results from his recent blood work and EEG. I suffer from severe anxiety and depression myself and it's tearing me apart to see my father like this and not have any idea what his problem is.

Any suggestions as to what is wrong with him would be welcome. Thank you.
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http://www.livestrong.com/article/161959-what-are-the-causes-of-brain-atrophy/

This is a good article.  Volume loss means the same as atrophy.  

For your own anxiety and depression, get checked for Celiac disease and nutrition problems like vitamin D deficiency and iron deficiency and B12.  
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Dear Jenseattle, welcome to the medhelp forum. I can understand and much regards your concern for your father’s health. These symptoms are suggestive of vascular dementia possibly secondary to chronic small vessel ischemic disease. This is associated with a decline in cognitive function. CT/MRI evidence is essential for diagnosis. Treatment would include preventing its worsening by treatment of underlying disease like hypertension, diabetes and raised cholesterol. Therapy would include drugs to anti platelet drugs and drugs modifying the flow properties of blood. You can consult your neurologist with these issues. Hoping sincerely that your dad gets better. Take care.
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