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I had extreme headaches with bp 186/106. MRI showed a change…

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I had extreme headaches...

I had extreme headaches with bp 186/106. MRI showed a change in white matter most common with microvascular disease. what does this mean?

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

Constant but also episodes of extreme with some nausea

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Nausea may have been from pain meds

Submitted: 7 months ago.Category: Neurology
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Answered in 44 minutes by:
12/12/2017
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 7 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,336
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I see your brain mri scan has showed the finding as you have mentioned above. As a Neurologist I read and interpret brain mri scan films very frequently and am very familiar with this type of brain scan findings, and I can certainly help you in this regard.

First coming to the terminology they have used, miscrovascular disease = these are changes in the white matter of the brain in the form of the presence of small spots and these spots are due to involvement of the smaller arteries, rather than large arteries supplying the brain, that is why they use the term microvascular, micro = small, vascular = arteries in this context, so involvement of the small arteries supplying the brain are affected. And this change is seen in the while matter of the brain. Cortex is the outer most layer of the brain and the white matter of the brain is located under the cortex. So this microvascular or small vessel disease is seen in the white matter of the brain.

Please see most of the times the spots what we see in the white matter such as yours ones are benign in nature

These types of spots seen in the MRI scans of the brain are most often not suggestive of any pathological conditions or anything serious in nature

This type of finding is commonly seen in the mri scan. And majority of people do not have any identifiable underlying cause to explain these spots and these spots are not going to cause any kind of problems currently or in the future

If you are having a history of high blood pressure, diabetes, high cholesterol, high triglycerides, or a history of long term smoking or long term heavy drinking then these spots can be secondary to the above. I see you are having issues with high blood pressure so this mri finding could be secondary to the high blood pressure too. If you have the other medical condition that I have mentioned above then these too could cause or contribute to these spots, if high blood pressure is the only medical condition you are having then this could be secondary to high blood pressure.

And these types of spots are not due to neurological diseases such as MS (Multiple Sclerosis), Strokes, Tumors or any other serious health conditions affecting the brain

Coming to the treatment aspects of these spots – in your case the blood pressure need to be aggressively managed, and this can prevent this condition occurring or worsening in the future.

Certain dietary modifications too can help – for example trying a special diet called as the Mediterranean diet which is characterized by intake of low animal fat/low cholesterol, rich in vegetables, fruits, lean meat, fish, legumes, nuts etc is recommended.

Daily and adequate exercise too can help.

If obesity or overweight is an issue then weight loss is also recommended (not applicable if weight is not an issue).

All these above measures including aggressive control of blood pressure will help in preventing further damage to the small blood vessels in the brain and prevent development of more spots (microvascular changes) in the brain in the future.

I once again reassure you this microvascular change (spots in the white matter of the brain) is brain is not serious and most patients will never develop any complications due to this condition, and also by doing adequate exercises and proper dietary adjustments, including aggressive control of the blood pressure - as pointed above can help in preventing any further development or any worsening of this change seen in the mri scan of the brain, and once again this finding seen in the mri scan of the brain is not indicative of any serious illnesses, so please not to be scared.

Please let me know if you have any additional questions or if you want to discuss this further.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Neurologist: Dr Subbanna MD, Neurologist (MD) replied 7 months ago

Hi, Do you have any additional health questions? Do you want to discuss this further? Please let me know and I am available here.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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