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Is Progression Of Small Vessel Disease Stoppable?

Posted on Sun, 9 Mar 2014

Question: I have recently had a query about small vessel disease. I am 62 and recently had an MRI scan. My doctor didn't seem concerned but I am anxious. He said I had a small amount of wear and tear in the brain. In a recent reply from one of your doctors I was told told it was possible to arrest the progression of the disease by using statins, asparin and keeping BP low. I have low BP and just below average cholesterol. I want to know if the progression of this disease is stoppable? I know it develops slowly and i don't have any present signs of cognitive impairment.

Answered by Dr. Sudhir Kumar (8 hours later)

Brief Answer: Yes, disease progression is stoppable. Detailed Answer: Hi, Thank you for getting back. Since the risk factors (for disease progression) are well under control in your case, we can be sure that the small vessel disease would not progress in your case. Your BP is low, and as per research, you have the least chance of worsening of small vessel disease (even lower than people with normal BP). In addition, your cholesterol and blood sugar are also normal. Other steps to ensure that the small vessel disease does not progress are: 1. Weight reduction, if overweight, 2. Regular physical activity and exercises, 3. Brain exercises, such as solving crossword puzzles, sudoku, etc. 4. Avoiding stress, tension and anxiety, 5. Eating well balanced and healthy diet. I hope it helps. Please get back if you have any follow up queries. Best wishes, Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (30 hours later)

Dear Sir thank you for your reply. As well as the problem with SVD I have mild vertigo. The doctor has prescribed Prochlorperazine 5mg. Also known as Stematil. Looking in the accompanying leaflets it suggests that elderly patients with dementia or related brain disease should not take this because of the risk of stroke. Is this related to a physiological result or the lack of stimulation. At the moment there seem to be nothing that does the same job with the vertigo available? Is there anything that does not have these side effect?. Would they be XXXXXXX in my case at the low dose - under 10=15mgs a day? Thank you for you attention in this matter. I found your last post very reassuring.

Answered by Dr. Sudhir Kumar (4 hours later)

Brief Answer: Betahistine would be better. Detailed Answer: Hi, Thank you for getting back. I agree that stemetil should be avoided (commonly used in India too) in your case. Even though there is a very small risk of stroke, why should we expose to that risk? Betahistine tablets are much safer, as well as very effective for controlling vertigo. For my patients, I use betahistine at a dose of 16 mg three times daily, and I have found it to be safe. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar