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Microvascular Ischemic Disease

Many people have MRI of the brain for different reasons like migraines, multiple sclerosis type symptoms, head injuries, and more.Lesions seen on an MRI scan can be really concerning.There are many different causes and microvascular ischemic disease is a possible sign of a future stroke. When this condition is found, doctors need to find the cause and treat it early on to prevent further blockage of the blood vessels in the brain. This article will help you understand more about this condition, how it is treated, and the prognosis. Also included are pictures of MRI scans to see what it looks like.

What Is Microvascular Ischemic Disease?

Microvascular ischemic disease shows up as tiny blood vessels in the brain that are blocked. They have either ruptured or filled with clots. When this happens, the area of brain tissue around the blood vessels dies off. This is the same as when a stroke happens. The areas are so small that patients may not have any symptoms and don’t even know it is happening.

The changes in these blood vessels can add up over time. This can lead to dementia, neurological issues, and memory problems. It can also be the sign of an increased risk for strokes in the future.

Causes of Microvascular Ischemic Disease

This condition is most common in people who suffer from health issues like diabetes, hypertension, and high cholesterol. It can also be a sign that you have blood vessel disease near your heart. Blood vessel narrowing can also happen when you are under emotional stress or during physical activity. Smoking and age are also risk factors that can lead to small blood vessel disease in the brain.

Symptoms of Microvascular Ischemic Disease

Another concern is that vascular disease in the brain can lead to dementia and Alzheimer’s. When there is a lack of blood flow to the brain tissue, the symptoms are usually cognitive. These include:

  • Memory Issues/Mild Dementia
  • Inability to Reason/Loss of Logic/Cannot Multitask/Disorganization
  • Depression
  • Apathy
  • Personality Changes
  • Emotional Incontinence (Laughing or Crying at Inappropriate Times)
  • Slowed Movements/Rigid Muscles/Trouble Walking
  • Frequent Falls
  • Weakness (One-Sided)
  • Speech Problems
  • Trouble Swallowing
  • Blurred or Double Vision
  • Aphasia (inability to Speak)
  • Loss of Ability for Motor Movements
  • Loss of Visual Field
  • Inability to Feel Sensory Stimuli
  • Personality Changes/Irritability/Anger/Overly Sweet or Affectionate

How Is this Condition Spotted?

Since there may be not symptoms at all, microvascular ischemic disease may go unnoticed until you have an MRI of your brain for other reasons. Many people discover they have this issue when undergoing MRI forcognitive impairment, migraine headaches, memory loss, symptoms of multiple sclerosis, or head injury.

Here are some pictures of MRI with and without blood vessel disease:

Figure 1: Normal MRI

In the picture above, there are no white spots seen in the brain tissue. Calcifications, narrowed blood vessels, and blockages show up as bright white or white spots in the tissue. They appear bright as if they were “lit up.”

Figure 2: MRI of the Brain with Ischemic Changes

In this MRI of the brain there are multiple white spots that appear very brightly in the brain tissue. These are signs of microvascular ischemic disease in the brain tissue. If the patient is given and infusion of gadolinium, the spots will appear even brighter on the MRI film. This is a type of contrast so the radiologist can differentiate different changes in brain tissue.

Is MicrovascularIschemic Disease a Serious Condition?

Small cases of microvascular ischemic disease without underlying health conditions may not be anything to worry about. Doctor’s begin to worry about the findings when there is underlying hypertension, kidney disease, diabetes, and a smoker.

If high blood pressure is not brought under control with this condition, there can be a seriously high risk for a stroke. The lesions seen in Figure 2, are actually “mini-strokes,” and they can actually turn into full cerebrovascular infarction or major strokes. When doctors see these changes in the brain, they do take the condition seriously if the above risk factors are present. Then they take steps to treat the condition.

What Is The Treatment for MicrovascularIschemic Disease?

There is no cure for microvascular ischemic disease and the damage isn’t reversible. You may be sent to physical therapy to deal with the effects on your body. They will also work to bring any other health conditions under control. This includes:

  • Strict blood sugar control for diabetics
  • Controlling hypertension
  • Quit smoking
  • Keeping cholesterol under control

Any underlying cardiac conditions will need to be monitored closely and treated with cardiac medications and/or low dose aspirin.

Experiences of Other Patients

“I was hospitalized 5 weeks ago with dizzy spells, trouble keeping my balance, and issues with coordination. I have a previous history of stroke 8 years prior. I am diabetic, with high cholesterol, and high blood pressure. My doctor just monitors me, but when I was hospitalized 9 weeks ago the doctor let my family know that my condition was serious. I am 70 years old. My doctor said I need to get my blood sugar, cholesterol, and blood pressure under control. My MRI showed microvascular ischemic disease. I have to make some serious lifestyle changes.”    —Mary

“I am 58 years old and I work full time in an office environment. A few days ago, my colleagues and I were having lunch and I passed out. They called 911 and I was taken to the emergency room. A CT and MRI scan was done and I was diagnosed with Microvascular ischemic disease. They said it was both age related and my history of diabetes. They did not give me any new medications, but put me on 81mg aspirin daily and I need to really watch my blood sugar levels.”    —Susan

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