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Wednesday, September 20, 2017
Chronic ischemic small vessel disease
My recent MRI T2 and FLAIR images showed right frontal subcortical white matter 5mm x 3mm old lacunal infarct or prominent perivascular space and PONS central diffuse increased signal seen on the T2 and FLAIR images suggestive of moderate to severe chronic ischemic small vessel disease. I am 59 years old, my family on both sides have died from strokes or heart attacks. My blood pressure is OK. My bad cholestrol is high and I take Zetia, but my good cholestrol is good. I want a down to earth answer with no flowers as to what this means. I cannot get a straight answer as to if I am likely or prone to have a stroke and what needs to be done. Please can you help me.
Please refer to previously answered questions, as well as a prepared document about interpretation of MRI findings, to obtain an understanding of what is meant by ischemic small vessel disease, which could also be called white matter disease.
You have risk factors for stroke: a family history, high cholesterol, etc. It is important for you to continue to work with your local physician to modify the risk factors as much as possible--just like you are already doing by taking Zetia to reduce your cholesterol.
Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati