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White spots on MRI scan - risk from stopping aspirin
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White spots on MRI scan - risk from stopping aspirin

I am male aged 59.  10 years ago I suffered from severe headaches as well as anosmia. It was suggested that an MRI brain scan should be undertaken (presumably to rule out the remote possibility of a brain tumour).  The MRI scan was more or less normal - except for some white spots (perhaps 10-20 on one of the "scan pictures") each measuring ~1 mm x 2 mm.  The neurologist commented that these white spots probably arose from "exhausted/thrombosed blood vessels".  I was advised to take one aspirin tablet a day to thin my blood and I continued with this until a year ago.  In addition, a couple of years after the MRI scan, due to the onset of high blood pressure, I was prescribed losartan 50 mg and also one of the statin drugs 10 mg to lower my cholesterol level.  

Well a year ago, I suffered torrential rectal bleeding as a result of diverticular disease. Then a total colectomy was performed.  At the time of the rectal bleeding, my GI specialist told me to stop taking the aspirin tablet because, I assume, that he wished to minimise the severity of any future rectal/GI bleeding that might occur.

I would like to seek your advice on whether you believe that, by ceasing to take aspirin, I may be "compromising what is going on in my brain" (whatever that might be).  Although it is highly likely that the rectal bleeding originated in the colon, there is still a chance that it may just originate in the small intestine and I would be loath to re-commence aspirin if I unwittingly cause further intestinal bleeding.  Also what is the significance of the white spots on the MRI scan?
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Avatar_n_tn
Aspirin and other NSAIDS (nonsteroidal antiinflammatory drugs) such as motrin can cause erosions in the lining of the gastrointestinal tract and may increase your risk of further bleeding.

White spots on the MRI scan are non-specific. Although I cannot really tell you exactly what they are without seeing the MRI scan, what you describe in the setting of high blood pressure, it represents hardening of the very small arteries supplying the brain. Other causes include migraines, MS (but not in your case) or unknown.

There is scientific evidence for aspirin in the secondary prevention of stroke (that is, patients who have already had a stroke), and in certain other groups ie diabetics, coronary disease. There is no proven scientific evidence for aspirin for just spots on an MRI. That being said, there may still be some benefit if you have some stroke risk factors (like blood pressure and cholesterol), but that is unkown at this point. So there is no absolute indication for aspirin in your case

there are alternatives to aspirin for stroke prevention which do not cause erosions (but may still increase bleeding due to thinning of the blood), like Clopidogril, but you would need to be evaluated by a neurologist or stroke specialist to see if you really need it.
Good luck
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