Hi, I had asked a question to double check some information received earlier from you, I have not received any reply from you, it looks like you do have history of high blood pressure and high triglycerides and also it seems you are a smoker, and I will give you my answer assuming that you have high blood pressure, triglycerides and also you are a smoker, if this is incorrect then please let me know.
Coming to the discussion;
You have asked a question whether the MRI spots seen in your report imply any brain injury in the deep white matter of the brain
The answer is both yes & no, this is because these spots could mean brain injuries, but even some normal people too show these type of brain spots. In some these spots may cause symptoms, and in some these spots do not cause any symptoms.
These types of brain spots can be seen in patients with chronic migraine
Patients with high blood pressure, triglycerides too can develop these spots – it appears that you have mentioned you are having these medical conditions, so these spots could be related to these. These medical conditions should be strictly controlled to prevent further development of these spots in the brain. Similarly smoking too can cause these spots, so quitting smoking too is recommended
As pointed above many times even normal people too have these type of brain spots
Rarely these spots can be due to conditions like MS (Multiple Sclerosis), or Cerebral vasculitis, chronic infections or inflammation of the brain, vitamin deficiencies, thyroid diseases, lyme disease etc too can cause these type of spots in the brain
If a spinal tap (lumbar puncture) has not already been done then please ask your neurologist to arrange for one, and the CSF (Cerebro spinal fluid) collected during spinal tap can help further, it can tell whether you have conditions like MS, or any other central nervous system chronic infections, or inflammatory conditions etc
If not already done then you also need an Angiogram study of the brain. Angiogram test is the study of the arteries supplying the brain (it will help to rule out conditions like brain vasculitis), and this test also checks for the blood flow within the brain. If this test is not already done please ask your neurologist for this test too
I am not sure whether you had blood tests to check for the thyroid, vitamin b12, folate, vit D level etc, if not already done then you need blood tests to check for these too, any of the above vitamin deficiencies, or thyroid disease etc can cause your symptoms
If blood test was not done to check for conditions like autoimmune connective tissue disorders then you also need blood tests to look for these possibilities, and blood tests like ESR, CRP, ANA, RA factor etc can help in this regard
If you were exposed to tick bites & lyme disease then you also need blood tests to check this possibility too, if not exposed then this test is not must
As discussed above there are various possibilities to explain the brain MRI findings and the symptoms you have mentioned, you may please ask your neurologist to arrange for the various investigations discussed above and then treated appropriately depending upon the test results.
Please let me know if you have any further questions, and please click a positive rating to credit for the time & effort put by me in answering your question.