periventricular small vessel ischemic changes

My mother recently had an MRI and it showed periventricular small vessel ischemic changes in her brain. Could you please explain what this means in layman's terms. She is 81 years old and has been experiencing tingling and numbness episodes on the right side of her face, hand and foot.

Thank yoiu,

Debbie Zabor

[CCFNeuroMD JT, MD]

I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

This “periventricular small vessel ischemic change” identified in the MRI report is a very common finding in the aged brain, strongly associated with hypertension.  This finding is generally a manifestation of atherosclerosis (AKA “hardening of the arteries”) related to high blood pressure.  The word “ischemic” indicates a loss of blood supply to a particular region of the body.  In this particular case, the very small blood vessels that supply some of the deep white matter in the brain are affected.  Oftentimes, these small vessel changes are incidental findings without clinical correlate (i.e. asymptomatic).  People with an extensive burden of small vessel disease may have manifestations of cognitive decline, AKA vascular dementia.  

It is unlikely that the tingling and numbness of the right side of her face, hand, and foot are related to the small vessel disease evident on her MRI.  However, given that she has evidence of diseased white matter, she likely has risk factors for stroke, the major ones being high blood pressure, high cholesterol, cigarette smoking, diabetes, cardiac arrhythmia (especially atrial fibrillation), and blood clotting disorders.  The numbness you mention may be a sign of a small stroke involving the very small, deep penetrating arteries of the brain.  These types of stroke, also called lacunar strokes (from the Latin root lacuna meaning “empty space”), may be so small that they are not always apparent on an MRI.  In your mother’s case, it sounds like her symptoms are purely sensory, perhaps suggesting a small “lacune” in the thalamus, which is the relay center for the brain.  

At this point, the best way to proceed is to see a neurologist who can examine your mother and provide you with a plan of care specific to your mother.  For most patients in her condition, the best treatment is prevention, meaning risk factor modification.  I hope I’ve answered some of your questions.  Best of luck!

[Lorim119]

I had an mri done I am 42 years old  foci of high signal in the deep white matter consistent with small vessel ischemic change and or gliosis. also the left side of the pituitary is larger than the right . Foot notes: There is evidence of small vessel ischemic change with several foci of high siganl within the deep white matter.  I dont have high blood pressure.  I was referred to a endoconologist. Can you tell me what this means please.
Tnanks

[Cheryl1057]

I had an MRI recently and my GP tells me I have an acute infarc with ischemic change of vessels and stroke-like lesion.  What the heck does this mean?  Have I had a stroke?  I've had a headache for 7 weeks now and am 52 years old.  What do I do now?

[mms556]

I am 39 and healthy, run 20mins on the running machine and does excersise 3 times a week min including swimming. I had 2 MRIs within 4 years which showed minimal changes regarding the load in the brain but the neuros seem to be "excited" about these lessions and suggested MS. They cannot however, distinguish " Dawsons fingers or any spots present within the Circle of WIll's. I have been suffering from chronic sinusitis and have recently been on antibiotics for a month. My ENT doctor was convinced that the presence of the polyp in the nasal cavity resulted in intracranial pressure and cause ON (caused 2 months before the ENT diagnosis. However, the neuro would not have it, despite my cervical cord being clean and refused to discuss the possible diagnosis. I declined the offer of CSF and suggested that the lessions could be from difficulties at birth and the migraine caused by sinusis. I have not told that I have a rare form of platelets HPA-1b homozygous (present in 1% of the population) which is important for blood clotting.  Would that make a difference? I feel a bit annoyed and that the neuros overinterpretation of data for just a T2 flair MRI! We are biological systems and abnormal should be replaced by atypical, meaning that everybody is an individual!  I have no other physical symptoms as such and I feel a bit let down.

[tybusiness43]

Good Morning, I am a 46 year old female in good health as far as my yearly exams are concerned. I experienced an episode on 12/22/2010 of a sharp pain traveling up my right arm and down into the left side of my chest, a weird sensation across the back of my eyes and mild numbness on the top of my right arm in the center between my hand and elbow. I took an Alieve and went to bed. The next morning I felt a little staggery when I walked to the bathroom. I noticed that the vision in my left eye was a little more blurry than before. (I wear glasses and my left eye is weaker than the right) I do not have high blood pressure or diabetes.  My lab work was described by the ER doctor as "Like a 20 year old" My weight is 150. During the last physical exam, my Cholesterol reading was.  I try to stay on a regimen of juicing my fruits and veggies. I try to keep a diet of talapia and ground turkey for meats and Pecans for snacks. I do use Protein Powder shakes with vitamins from A to Z that have 25 grams of protein per serving but it's not on a daily basis. I do, however, have a lot of stress in my marriage and I'm dealing with my grown daughters and their life issues. It's been a lot of stress over the past 7 years.

I took a visit to the ER by paramedics on 12/22/2010 just to be safe. I had an MRI of my head and neck that read the following:

Nonspecific white matter, FLAIR hyperintensities in the subcortical left frontal lobe and right corona radiata statistically related to small vessel ischemic changes. Otherwise, unremarkable MRI the brain.

Can you please tell me what this reading means?  I have not seen a doctor since the incident on 12/22/2010, but I'm scheduling an appointment with my primary care and a Neurologist ASAP. The ER doctor said that my symptoms were not "A Specific" to a  Stroke so he released me from the hospital visit with no medication. He instructed a follow-up though. I've been tested, in the past, for Lupus on 2 occasions by my primary care doctor and the tests were negative. I am very concerned about the vision in my left eye because I have to wear my glasses to see properly since the incident. In the past, I was instructed by my ENT doctor to use a nasal rinse, which has given me some relief from the sinus pressure that I experience. The last MRI I had about 7 years ago was normal, but there was a lot of swelling in my sinuses. My last CT Scan did not show a stroke either.

Thank you in advance for your advice

[tybusiness43]

I apologize, my Cholesterol reading was 206, the LDL was 140 and my HDL was 47. My doctor said that I needed to bring the LDL down a bit. The FLAIR Hypertensities were T2. I do not drink or smoke.