Two weeks ago, I had a "near" fainting episode. No symptoms were noted until two days later when I could recall only two of the four numbers for my debit card. When presented with those numbers - there was no recall of them. No other symptoms have been noted. I am 72 years old, am treated for high cholesterol, exercise regularly and am normal weight. Ultrasound of my carotids and heart were normal but the MRI final diagnosis was : Mild chronic white matter changes. Otherwise, unremarkable MRI of the brain. Noted in the body of the findings was: " a few scattered periventricular white matter T2 signal foci which do not cause mass effect. These are most suggestive of chronic small vessel ischemic changes." My questions are: 1) How serious is this diagnosis and 2) what actions do you suggest for me.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
There are multiple causes for so called white matter changes, or plaques, in the brain. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented.
Other causes of plaques in the brain can be migraine. People with migraine often have plaques on their MRI that are of unclear cause or significance.
Other causes of plaques on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to, multiple sclerosis, other demyelinating disease, and inflammatory processes such as vasculitis.
The different causes can be determined to some extent by interpretation of various sequences of the MRI.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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