ischemic white matter disease

[abusylady]

My Friends husband has been diagnosed via a CT scan with " Chronic ischemic white matter disease".  He is a diabetic that fell and hurt his knee then was laid up in bed for 3 or 4 days and developed a severe UTI.  She took him to ER they admitted him with agitation, disorientation, confusion etc.  Doctors at the Hospital told nothing on results and transfered him to re-had nursing care.  What causes this... is it reversable or is there a treatment to slow it down? Are there other detailed tests that can be run to clarify cause and effect etc?

[LivingInHope]

I was speaking in relationship to an immediate family's case of white matter chronic microvascular ischemic changes.  He suffered a TIA and is on plavix now.  Another thing I've heard can cause microvascular changes to the white matter are chronic migraine headaches, which you would want to try to prevent as many as possible if possible.  Does your friend's husband suffer from migraines or chronic headaches?

Dr. Srivastava- what sort of metabolism errors would cause the changes?  My loved one rarely gets a virus- is there a specific virus that releases those toxins?  He does not have an autoimmune disease to our knowledge- but are there any specific ones that lead to the tiny vascular changes in the brain?  

My family member also does not have leukodystrophy which I looked up and found is degeneration that is progressive of the brain's white matter, owing to flawed development or growth of the the fatty myelin sheath covering, which serves as an insulator around nerve fiber: the most common symptom, I learned, occurs in children, and my loved one's definitely not in that category.  He doesn't have multiple sclerosis from demyelination, and has not had much in the way of radiation (other than a small number of diagnostic tests).  

[Dr. A. Srivastava]

Hi, Thank you for your question. Although without being able to placing your findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice & treatment you need. However, I will try to provide you some relevant information about your health concern.

In white matter disease or microvesicular ischemic disease of brain, pathology is associated with the brain white matter, either exclusively or in combination with grey matter changes. It occurs due to metabolism errors, exogenous toxins released by virus, autoimmune disease, leukodystrophy, demyelination, and radiation effects. Spasticity, muscle weakness, paralysis, hyper-reflexia and movement disorder may be the clinical features associated with white matter disease that need to be evaluated thoroughly. However, it is sad to say that there is no permanent cure but conservative treatment & physiotherapy exercises that would help you to regain your normal function and stopping the further progression of the disease. Please consult a neurologist in this regards. Hope this helps.

[LivingInHope]

Did they treat him for his severe UTI?  Did they run a urine culture on him afterward to be sure the infection was cleared up?

Well, some risk factors about ischemia in the brain's white matter include hypertension (high blood pressure), a lipid panel with high bad cholesterol and high triglycerides (which can lead to plaque formation), and aging.  

When the tiny blood vessels in the brain get clogged up with plaque, ischemic changes can happen to the white matter.  Ischemia is when there is a lack of oxygen to tissues.  The fact that they say chronic means they can tell the changes have been going on over a long period of time.  

Does he have high blood pressure?  If so, he should be put on appropriate blood pressure medicine to try and manage his blood pressure.  Is/Are his LDL and or triglycerides high?  If so, he may need to make dietary and exercise changes and might ask the doctor if they feel he should try medication.