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Treatment of white matter ischemia
My Uncle who is 82 years old is showing signs of forgetfulness and fatigue. He had multiple vessel coronory heart disease and had a successful heart bypass surgery in 1997. He also had TURP for prostrate in 2006 and it was successful. He has a Hemoglobin count of 18%. Hereunder please find his recent MRI report:


Spin Echo  T1 & T2 weighted axial, FLAIR coronal images were obtained.
MRA was done of the anterior and posterior circulation.

There are multiple, variable size, scattered and confluent areas of signal abnormality are seen in bilateral external capsule and corona radiata. Signal changes are also seen in bilateral deep parietal preventricular region, more marked around the occipital horns. The signals are low on T1W, high on T1W and FLAIR images. Findings are most likely due to multiple areas ischaemia and ischaemic infarcts of various duration on a back ground of white matter ischaemia.

There is no evidence of intracranial mass or bleed.

The cortical sulci and the ventricles are dilated representing age propotionate cerebral involutional changes.

There is no midline shift.

The sella, pituitary gland and cavernous sinuses are normal.

The vestibulo - cochlear nerve complexes are normal.

MRA showes the internal carotid, the anterior and middle cerebral arteries to be patent without evidence of any narrowing or occlusion in major vessels. No midline shift , mass effect or aneurysm is seen.

MRA of posterior circulation demonstrates dominant left with hypoplastic right vertebral artery. The posterior cerebral, basilar artery and its branches are normal caliber.

Minimal Mucosal thickening of the ethmoid sinuses are seen, representing mild sinusitic infection.

Mild deviation of the nasal septum to the left is seen anteriorly.

Hypertrophied left middle and inferior turbantes.

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