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Leukoaraiosis Causes

I was diagnosed with Multiple Sclerosis for the past 4 years.  Doctor was thinking primary progressive.  I am a 52 yr. old female who has Ankylosing Spondylitis and Ulcerative Colitis.  I had my yearly MRI and now the neurologist is saying not MS but instead, the radiological terms are “non-specific micro-vascular change” or “leukoaraiosis”.  My symptoms have been leg weakness, balance problems, muscle spasms, short term memory difficulties, left eye with Optic Neuritis.  If I don't have MS then what could it be.  I do not have high blood pressure, diabetes or high cholesterol, no strokes or TIAs, and CADASIL (unlikely, no relatives with it).  What else causes these brain lesions.  Neurologist says I have too many lesions to be age related.  They are multiple small foci of bright FLAIR signal in the subcortical white matter of both hemispheres in a relatively symmetric distribution.  Thank you.
5 Responses
292356 tn?1205033382
MEDICAL PROFESSIONAL
Dear dittledittle,
Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms.
I am limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

To begin, please allow me to explain the meaning behind "leukoaraiosis."
It is traditionally used to refer to abnormalities seen in the white matter or deeper brain tissue where most of the nerve connections pass.
The mechanism behind formation of the changes is poorly defined, but the specific changes seen on MRI's have been found to have a strong correlation to small vessel disease and strokes.
There is also an association between leukoaraiosis and dementia -- both vascular dementia (cognitive decline after multiple strokes) and Alzheimers dementia.
There are multiple case studies showing that leukoaraiosis clinically presents as cognitive impairment, assorted motor dysfunctions, and gait disturbances -- although this is inconsistent and not seen in all patients with these MRI findings.

Although you do not seem to have the obvious risk factors for stroke -- high blood pressure, diabestes, high cholesteral or previous symptomatic strokes you should investigate this further and get a full health screening by your primary care physician to confirm this.

Leukoaraiosis in many studies have been shown to predict increased risk of stroke and heart attacks.
You may have risk factors that you are not aware of because you haven't been tested recently.

If you smoke, stop.
Go to your family doctor and have your blood pressure and cholesteral panel checked.
If you are overweight, try to lose some weight.
If you do not exercise, start.
Most importantly, if you are not already on aspirin as a preventive measure to decrease your risk of stroke and heart attacks discuss it with your family doctor.
You should probably undergo routine screening as well -- this would include a carotid ultrasound and maybe transcranial doppler studies to make sure that your blood vessels in you neck and brain are not blocked.
Get routine cardiac screening as well -- EKG, stress test, etc.

I'm not telling to that you are going to have a stroke or a heart attack soon, but I do think that you should take steps to prevent a future risk of these as soon as possible.

Please remember that this MRI finding and its correlation to vascular disease is not set in stone, but the fact that you are having symptoms warrants evaluation.
Perhaps you can see a stroke or cerebrovascular specialist -- any of the stroke neurologists at the Cleveland Clinic are highly recommended.

THank you,
Hope this helps,
JKL, MD
Avatar universal
Hi
I have similar situation to you... multiple white matter lesions, frontal and parietal, irritable bowel, asthma, chronic fatigue, fibromyalgia, multiple chemical sensitivity and spondyloarthropathy. Difference is I know what happened. I expereinced heavy exposures to multiple indoor moulds and mycotoxins. The above is the unfolding, an immune system domino effect essentially. Toxins... formaldehyde offgasing from new carpets or OSB - particle board used in new buildings can cause such lesions and various tumors and cancers. Examine your air quality..... are there factors that put your health at risk? Also toxins in stain retardants in clothes, carpets, fire retardants in drapes...on and on. Try an environmental health specialist and research for yourself.
There is demonstrated relationship between mould toxins and brain lesions. See Chronicneurotoxin website for help. Omega 3's helps brain function. A naturopath may be helpful.

All the best

Optomistic and resisting
Avatar universal
Mould would not be a factor for me.  I live in a dry climate.  Have the doctors diagnosed the brain lesions to any disease?  I haven't had heavy toxin exposure.  I do take Omega 3s.  You must have worked in construction?  I appreciate your comments and am seeking another neurologist opinion.  For the ankylosing spondylitis are you on Remicade?  Take care...
Avatar universal
I am a 36yr old female who up until moving into my newly constructed home in Nov 05 was perfectly healthy. In Feb 06 I started experiencing severe migraines,Tacycardia,Insomnia and uneven pupils. The MRI findings showed T2 unspecified white signal matter and after 6 times in the hospital on IV Dilaudid-we moved out in May 07 and I have sensitivities to almost everything now and I cannot go in my house as I immediately get a headache as does my husband and children. My 10yr old also was getting multiple nosebleeds and my husband has developed asthma-all this from our home. My brain gets very foggy and both my husband and I have no short term memory left. We have tested the house for mold and although there is some-probably not enough to make us so sick!!
We are totally baffled and the builder will not help us in any way!!
Avatar universal
A related discussion, Leucoariosis was started.
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