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I Am Suffering From Bilateral Amaurosis Fugax. MRI Of Brain Done. Advice Some Medication And Precaution?
Question: Hello ! Sir,
I am 50 yrs.Male. My MRI Brain finding- Bilateral XXXXXXX periventricular white matter and centrum semiovale region show multiple tiny T2/FLAIR hyperintensities-non-specific old micro vascular ischemic changes. My weight is 70 Kg. I was advised MRI as I am suffering from bilateral amoursis fugax (transient blindness in both eyes) happening after every two or three months. My BP is normal. Please advise prognosis, risks, remedy, medications and precautions. Thanks
I am 50 yrs.Male. My MRI Brain finding- Bilateral XXXXXXX periventricular white matter and centrum semiovale region show multiple tiny T2/FLAIR hyperintensities-non-specific old micro vascular ischemic changes. My weight is 70 Kg. I was advised MRI as I am suffering from bilateral amoursis fugax (transient blindness in both eyes) happening after every two or three months. My BP is normal. Please advise prognosis, risks, remedy, medications and precautions. Thanks
Hello XXXXXX,
Thanks for writing.
I am a medical specialist with an additional degree in cardiology.
MRI show microvascular ischemic changes of older time you might have had transient ischemic attack (associated with some neurological deficit recovered in few hours called TIA) In fact underlying pathology of both TIA and Amaurosis fugax is the same that is lack of blood supply which is transitory and restored in a period of time in few hours due to either of 4 causes:
1. Spasm of the vessel
2. Thrombus in the blood vessel which ulcerate with time
3. Embolus/ emboli (blood clots) in the vessel which dissolve with the time
4. Problem with blood like sickle cell anemia (not so common in most of India)
If the etiology is found that what is throwing thombi into the artery like neck artery or heart and is treated, the neurological deficit (loss of vision is also a neurological deficit) will keep on re occurring in most. Therefore, your MRI was done.
Please recount and tell how many attacks of blindness you have had? Did you ever have deficit in other part of your body? What treatment you are taking and from where? Do you have any other risk factors like Diabetes, high cholesterol or atherosclerosis anywhere else like heart disease? I take from IP address that you live in Delhi which has many good hospital I may be able to suggest one. Good luck. Looking forward to your answer. Unless I know more, it is not possible for me to say that attacks will not occur again.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Thanks for writing.
I am a medical specialist with an additional degree in cardiology.
MRI show microvascular ischemic changes of older time you might have had transient ischemic attack (associated with some neurological deficit recovered in few hours called TIA) In fact underlying pathology of both TIA and Amaurosis fugax is the same that is lack of blood supply which is transitory and restored in a period of time in few hours due to either of 4 causes:
1. Spasm of the vessel
2. Thrombus in the blood vessel which ulcerate with time
3. Embolus/ emboli (blood clots) in the vessel which dissolve with the time
4. Problem with blood like sickle cell anemia (not so common in most of India)
If the etiology is found that what is throwing thombi into the artery like neck artery or heart and is treated, the neurological deficit (loss of vision is also a neurological deficit) will keep on re occurring in most. Therefore, your MRI was done.
Please recount and tell how many attacks of blindness you have had? Did you ever have deficit in other part of your body? What treatment you are taking and from where? Do you have any other risk factors like Diabetes, high cholesterol or atherosclerosis anywhere else like heart disease? I take from IP address that you live in Delhi which has many good hospital I may be able to suggest one. Good luck. Looking forward to your answer. Unless I know more, it is not possible for me to say that attacks will not occur again.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the prompt advise. I am answering to your queries as well as I have some.
My main query is that: How is white matter changes going to affect my health (as per the findings of MRI).
Further, I do not have diabetes. I do not know whether I am having arterioscelerosis. I don't have any deficit in any other part of the body including sexual function. The attacks of transient blindness have been occurring since last two and a half years or more very intermittently may be thrice or four times in a year. My cholestrol is on border line for which I have been advised Storfib 10 mg and also I am also on Ecosprin 75 mg since one week.
I have been advised the following tests:
1. Echo/TMT
TEE including contrast study for PFO and Arch
2. MRI Brain
3. MRA Carotid/Vertebral from Arch to Circle of Hillis
4. Heamocystine
5. Folate, D3
Are all the above tests necessary.
Thanks.
My main query is that: How is white matter changes going to affect my health (as per the findings of MRI).
Further, I do not have diabetes. I do not know whether I am having arterioscelerosis. I don't have any deficit in any other part of the body including sexual function. The attacks of transient blindness have been occurring since last two and a half years or more very intermittently may be thrice or four times in a year. My cholestrol is on border line for which I have been advised Storfib 10 mg and also I am also on Ecosprin 75 mg since one week.
I have been advised the following tests:
1. Echo/TMT
TEE including contrast study for PFO and Arch
2. MRI Brain
3. MRA Carotid/Vertebral from Arch to Circle of Hillis
4. Heamocystine
5. Folate, D3
Are all the above tests necessary.
Thanks.
Dear XXXXXX,
Yes these tests are absolutely necessary. For all practical purposes you have atherosclerosis of vascular system involving your eyes. And we do not know
a). Where the emboli arising from which test number 1, 1a, 3 will tell.
b). What are the other organ organs involved silently which is same as 1 but what
is it which is making you to predisposed to this rather serious illness. The tests
4 & 5 will complete picture. These are treatable/partly treatable risk factor and'
we want you back in good health. Knowing the recurring nature of disease we
(and I am including you treating doctors in this we) want you never to have
blindness episode or involvement of other organs with the same disease
process, for that certain tests are needed.
I hope I have answered your question, if you have any further doubts you are most welcome to ask, shall try to answer asap. Regards.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Yes these tests are absolutely necessary. For all practical purposes you have atherosclerosis of vascular system involving your eyes. And we do not know
a). Where the emboli arising from which test number 1, 1a, 3 will tell.
b). What are the other organ organs involved silently which is same as 1 but what
is it which is making you to predisposed to this rather serious illness. The tests
4 & 5 will complete picture. These are treatable/partly treatable risk factor and'
we want you back in good health. Knowing the recurring nature of disease we
(and I am including you treating doctors in this we) want you never to have
blindness episode or involvement of other organs with the same disease
process, for that certain tests are needed.
I hope I have answered your question, if you have any further doubts you are most welcome to ask, shall try to answer asap. Regards.
With Best Wishes
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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