Brief Answer:
Aging is STRONGEST risk factor for microvascular disease of brain

Detailed Answer:
Good afternoon Ms. XXXXXX-- My name is Dr. Dariush Saghafi and I'm an adult Neurologist from the XXXXXXX OH part of the world. I'd like to give you some thoughts on your statement above. I'm afraid I can't quite ferret out your question because as you've stated things....there will isn't a question. I did read your little blurb above it and it states that you're being looked at at JH for a possible genetic syndrome but that the micro-ischemic part of this equation has not been attributed to anything but normal aging.

Therefore, my assumption is that you would like to know whether or not the micro-ischemic disease of the brain (am I correct in assuming that particular organ?) is part of whatever possible genetic syndrome you may have or can it truly be just a function of the aging process?

That's a difficult question to answer based upon the limited information you've provided and I'll explain why. First of all, if you've been doing any reading on the subject then, I'd like to make you a bit conversant with terminology you'll run up with so that you don't think they're talking about different things. Also, in my discussion below I may tend to use other terminology that I'm more accustomed to using so again, I don't want you to get confused thinking that I'm talking about something altogether different from your problem which you are calling micro-ischemic disease.

Micro-ischemic disease can also be called "white matter degenerative disease", "small vessel ischemic disease", "deep white matter ischemic disease", "small vessel disease", "small vessel white matter disease", "microvascular ischemia" and some radiologists may even refer to the WMD entity in the films and state that they cannot conclude 100% that they're not looking at some form of DEMYELINATING disease. Typically, demyelinating disease is more reserved for things such as MULTIPLE SCLEROSIS, SARCOIDOSIS, and other inborn errors of metabolisms, genetic issues such as METACHROMATIC LEUKODYSTROPHY, etc.

Now, in your case since you are saying that the micro-ischemia is of a MILD degree then, I think the more likely scenario is that it is UNRELATED to whatever else is going on that you're being evaluated for at JH. Had it been part of a bigger syndrome then, I'd've expected the white matter changes to be more significant and widespread.

Here is a short list of the risk factors for this type of problem WITHOUT it being included in any genetic syndrome-- Do you have any of the following?

1. Aging (usually seen in ALL of us as we get beyond the age of 50-60, and certainly by 70 and above) there will be evidence of deep white matter disease.

2. Current or former smoker? Even if a former smoker from decades gone by there can still be evidence of WMD of a micro-ischemic nature which can be detected by imaging studies such as MRI.

3. Hypertension (either controlled or not well controlled)

4. Diabetes (again, either controlled, uncontrolled, so-so controlled, Type I, Type II)

5. High cholesterol (controlled or uncontrolled)

6. Lacunar infarction of deep brain tissues

7. Unhealthy diet (high in carbs, high in SATURATED FATS

8. Lack of exercise

And so in conclusion YOUNG Ms. Shadygroveplants I believe that at the end of the day you will discover (or Johns XXXXXXX will discover) that your white matter ischemic disease is more likely the result of the vascular deficits that come about through the aging process in the brain as well as one or more of the above risk factors (and to be sure the list is not exhaustive....I just wanted to get this off to you fairly quickly).

The reason, as stated above, hinges on your description of the problem as "mild" which would be highly unlikely to be the case in an inherited or genetic disorder which would be linked to the other problems above but not have progressed through the decades to anything but a mild degree? Very unlikely.

I wish you well....and a Happy New Year with much health good stuff waiting for you and your family.

If this information has been helpful and I've answered your question satisfactorily would you do me the favor of some written feedback and a STAR RATING of the answer. Should you have no further questions or comments to place- CLOSING THE QUERY would be greatly appreciated as well.

In the future I'm happy to answer more concerns personally if you'd allow me this privilege by going to the following website and sending me your questions:

bit.ly/drdariushsaghafi

This query has required 60 minutes of physician specific review, research, and final draft documentation for envoy to this point.

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