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Cause of ISVD in younger person?



Hi, I have been diagnosed through an MRI and extensive CT scan with ischemic small vessel disease. I am only 45, female, with no history of HT or diabetes. I do drink and have a family history of stroke. My neurologist doesn`t seem to be concerned and says it does not constitute a stroke, but a couple of other specialists say I am too young to have been diagnosed with this. I have been experiencing a wide variety of symptoms and seeing a number of specialists. What could be the cause of my ischemic small vessel disease?Thanks in advance for any input.


This is the most common question that I encounter. White matter ischemic changes are extremely common on MRI scan especially in elderly patients with hypertension. However, if these changes are present in a younger patient with no history of hypertension, then further investigations to look mainly for inflammatory processes is recommended. It also depends on the severity of these changes. if the white matter changes are minimal then observation might be adequate. I am glad you are being seen by a Neurologist who should be able to determine the need for further investigation. In the mean time, minimize your risk factors such as reducing alcohol consumption, stay away from tobacco, low fat diet, exercise, eat healthy, and weight loss.

Regards and have a nice weekend.

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Response by:

Yousef  Mohammad, MD, MSc Yousef Mohammad, MD, MSc
Assistant Professor
Director, Stroke Fellowship Program
College of Medicine
The Ohio State University