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Avatar universal

Pregnancy Stroke

Had a pregnancy stroke (due to toxemia/hypertension) and seizure when I was 18.  No effects from either.  It is now 17 years later and I had some dizziness so I had an MRI done in March 2008.  

The findings from the MRI at age 18 (1992):
lateral ventricles are slightly large for someone at this age
2 to 2.5 cm wedge shaped area of low density involving the right superolateral frontal cortex consistent with an infarct there.  
right frontal CVA with minimal mass effect

The findings from MRI in March 2008... (the neurologist had nothing to compare to when doing this MRI)
multiple tiny chronic appearing non-enhancing foci of T2 signal change in the white matter of both cerebral hemispheres.  May reflect premature small vessel ischemic changes but areas of previous demyelination could be considered.  They do not appear active at this time.  Non specific in a patient of this age.  

Had a followup MRI done in January 2009 and nothing has changed... nothing is worse and no nothing new.

The doctor did say that if a toxemia stroke did happen, it is where it should be on the MRI.  I am hoping that the MRI is just old stuff and not small vessel disease.  He did say it was non specific and non fatal.  

Any thoughts?
3 Responses
Avatar universal
MEDICAL PROFESSIONAL
Hi,
Please read the following  - The doctor did say that if a toxemia stroke did happen, it is where it should be on the MRI.  I am hoping that the MRI is just old stuff and not small vessel disease.  He did say it was non specific and non fatal.  

These sentences are not clear . Please clarify them and let me know what your querry is .

Regds !
Avatar universal
My main concern is that I am worried I have small vessel disease.  I can't seem to get a straight answer from the neurologist.  Since it has been so long (17 yrs), he has nothing to compare the MRI to.  

Do any findings that I have mentioned above indicate small vessel disease?

Thanks
Avatar universal
MEDICAL PROFESSIONAL
Hi,
You may be having a small vessel disease .White matter change is a very common finding on an MRI scan. Frequently, these changes are seen in patients who have/have had hypertension, stroke, migraine headaches, or other medical conditions. As the brain ages, we tend to see a change in appearance around the fluid filled spaces (the ventricles). These changes are thought to be the long-term effects of atherosclerosis which cause less blood flow in these brain regions. Less blood flow means that the brain tissue can be irreversibly injured, which is referred to as "ischemic injury."
Some MRI reports may state that "perivascular chronic ischemic white matter disease of aging" is seen. We do know that we see increasing amount of these changes with age and see greater amounts of change in patients who have high blood pressure and diabetes. In a sense, this is the "end effect" on the brain of having risk factors such as hypertension or diabetes, although not all patients with either condition have such changes. Importantly, patients with these changes do not necessarily have any neurologic problems as a result, unless the changes are very severe. These changes accumulate slowly over time and the brain is able to compensate so that no function is lost. There is some evidence to believe that having white matter changes does lead to a slightly increased risk of stroke . So this small vessel disease could have been a cause of your stroke . Hope this helps you . Take care and regards !

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