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Thursday, August 17, 2017
I am a 74 year old woman in above average health. An MRI has shown Small vessel ischemic changes with chronic lacunar infarction in the frontal lobe deep white matter and mild atrophy with promincnce of the sulci and ventricles. My Doctor said that I had suffered a small stroke at some time in the past 20 years. I had no knowledge of having had a stroke at any time. I do occasionally have very bad migraine type headaches and that was the reason for the MRI. Am I at risk of having a serious stroke and could the stroke in the past be a reason for the migraine type headaches?
I have answered quite a few similar questions in the past. MRI findings such as you report are common with aging and do not necessarily mean that you suffered a clinical stroke.
Having migraine headaches makes it statistically more likely that white matter changes will be seen on your MRI scan, although age and high blood pressure (and then diabetes) are more common causes for these changes. These changes are not responsible for you having migraines.
There is some evidence to believe that having white matter changes (small vessel ischemic changes) does lead to a slightly increased risk of stroke. It is always worthwhile to work with your doctors to ensure that you are doing all that you can to reduce your total risk for stroke or heart attacks.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati