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Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 42819
Experience:  Experienced physician in Neurology
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I went to the er today with stomach issues and terrible

Customer Question

FOR DR DAVID I went to the er today with stomach issues and terrible headache. Because I have what they call an incidental cerebral aneurysm, which they have been watching for 3 years and it has been the same 2 mm, they did MRI and MRA to see if it had ruptured. They said it is the same and send me hoe with meds for headache and stomach and said I had a virus. They gave me copies of my results and one of the impressions on the MRI no contrast says, Minimal Chronic Small Vessel Ischemic changes of the brain. Says Aneurysm unchanged and otherwise unremarkable. They did not tell me anything about this, above it says, minimal areas of T2 and FLAIR hyper intensity in the cerebral white matter. I am very upset as of course I looked it up and it does not seem normal, can you explain what it means? also is I lower my cholesterol will that slow this down, if that is causing it?
Submitted: 9 months ago.
Category: Neurology
Expert:  Dr. David replied 9 months ago.

This is Dr. David

thanks for the question.

as we all get older, we can have small blood vessels break in the brain and cause small vessel ischemic changes.

you could have small broken blood vessels on your skin or body

these are these thing as what as seen on the MRI scan of the brain, small broken blood vessels

high blood pressure, obesity, diabetes, high cholesterol, smoking can all increase your risks for small broken blood vessels.

lowering your cholesterol, loosing weight, eating healthy will all help your blood vessels.

vitamin K wont hurt her.

her doctors need to check for a fistula where cancer in the rectum or uterus can grow into the bladder and cause blood in the urine and UTI infections.

a pelvic can can check for this

radiation can shrink the cancer possibly and help slow down or stop the infection.

let me know if you have other questions.

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Customer: replied 9 months ago.

I am sorry? There is stuff in reply to my question that has nothing to do with my ???

The 1st part does then the rest is not making sense to me.

I read this finding can indicate higher risk of stroke and cognitive and AD and parkinson issues later, like if becoming moderate to severe.

Also if I lower my cholestrol, which is the only risk I have to cause small vessel ischemic changes, can that stop this from getting worse, or slow it? I weigh 110, am 57, no smoking, low blood pressure....

Expert:  Dr. David replied 9 months ago.

you have to scroll up and down to see my whole response.

there is a scroll bar to the right.

as we all get older, we can have small blood vessels break in the brain and cause small vessel ischemic changes.

you could have small broken blood vessels on your skin or body

these are these thing as what as seen on the MRI scan of the brain, small broken blood vessels

Expert:  Dr. David replied 9 months ago.

small microischemic changes can over time can affect your thinking and you could become more forgetful

as we all get older, we can all become more forgetful

your age of 57 is a risk factor.

yes, lowering your cholesterol can help keep new areas of blood vessel breakage in the brain from getting worse

improving exercising can help as well.

Customer: replied 9 months ago.

my age is 52

so improving things like exercise which I have been and lowering cholesterol can slow this or stop it?

can this be cause my sjogrens or lupus? I read that my autoimmune disease can CNS stuff and legions in white matter are one, which are not really an issue for most sjogrens patients who get them?

Expert:  Dr. David replied 9 months ago.

improving your diet, exercising, eating good fats and lowering your cholesterol and exercising will help prevent new broken blood vessels in the brain.

this is not a sign of sjorgens or lupus.

Customer: replied 9 months ago.

ok I read the inflammation caused by autoimmune disease could cause this and remember my doc telling me with my level of autoantibodies CNS could be involved.

So if I lower my cholesterol and exercise and I keep the MRI reading at minimal will that lower chance of serious stroke or Alzhemiers and such from coming.

For instance at 52, would I be having smtpoms from this and if I don't get further damage will I stay like I am, or could i get AD from this minimal change?

Expert:  Dr. David replied 9 months ago.

autoimmune diseases are rare.

I bet an autoimmune disease is not causing these microischemic changes in the brain

I bet it would be your cholesterol causing your symptoms.

at age 52, you would have symptoms from autoimmune disease.

these microischemic changes will not cause alzheimers disease. that is not how it is started

let me know if you have other questions.

if done for now, please leave positive rating above the chat box so I can get credit for helping you today

we only get credit for helping clients after positive feedback

you can always reach me with "a question for Dr. David" in the medicine or oncology categories if you have any other questions

here is my website if you need to reach me again:

http://www.justanswer.com/medical/expert-dr-david/

Thanks for using JustAnswers.com

Customer: replied 9 months ago.

I do have many symtpoms from my Lupus and Sjogrens, not sure what you mean I would have symptoms, I do.... Many.

Every article I have read online, many article state that your risk of stroke is three times and before from article:

small vessel brain disease can lead to thinking problems. When severe, this is called vascular dementia. Although estimates vary, a June 2014 "BioMed Research International" article reports that blood vessel problems account for 20 percent of dementia worldwide -- second only to Alzheimer disease. Small vessel brain disease typically causes milder memory problems than

I am asking if I keep it mild and it does not get worse, can I keep this from happening, or does it always progress?

so I have read this small vessel ischemic disease increases risk of many things, dementia, parkinson, AD and stroke. what I am asking is if I keep my damage at what they call mild will that stop those things from occurring? If I was going to have problems with those things, would I have them now, at the minimal level?

Customer: replied 9 months ago.

Ok I am going to call and ask if they can open my ?? up. I am concerned that you are not getting the basic concern and also assuming my autoimmune disease is asymptomtatic without asking....your answer is not clear , so can you open this up, I will call now.

Expert:  Dr. David replied 9 months ago.

Vascular dementia does not happen to all patients who have miscroischemic changes in the brain

It happens to only a small percentage of patients

Customer: replied 9 months ago.

I called and asked just answer to change category to Neurology, they said I need to ask you to opt out so some one else can answer.

Thanks

I don't think you opted out so I will call back and ask just answer what to do, I have asked this question two times, and paid twice and am not paying again, I thought you would make it clearer, but not, so please opt out.

Customer: replied 9 months ago.

please OPT OUT of my question as i asked

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