What Causes Chronic Microvascular Ischemic Change Of The Brain?

Posted on Mon, 20 Apr 2015

Question: I HAVE PARKINSON'S DISEASE FOR 14 YEARS AND I AM 60 YEARS OLD. I JUST HAD A MRI OF MY BRAIN SINCE I STARTED FALLING MORE FREQUENTLY. IT SHOWED A MINIMAL CHRONIC MICROVASCULAR ISCHEMIC CHANGES. DOES THAT HAVE ANYTHING TO DO WITH P.D?
please acknowledge you received the question

Answered by Dr. Ajay Panwar (12 minutes later)

Brief Answer:
These changes are not related to Parkinson's disease.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

If you would have presented to me as an outpatient with this complaint,I would have told you that chronic microvascular ischemic changes can be normally seen in brain MRI at your age.These changes are not related to Parkinson's disease.
However,sometimes parkinsonism is caused by ischemic changes in the brain.Such a type of secondary parkinsonism involves lower limbs more than upper limbs.Ischemia induced parkinsonism is characterized by rigidity in lower limbs,tremors being not that prominent.
So,if these specific features are associated with your parkinsonism,then it may be secondary to ischemia.Otherwise,if you have typical upper limb predominant,parkinsonism characterized by tremors and bradykinesia(a classical PD),then these microvascular changes should be taken as non-significant.

Also,Hypertension can aggravate such changes in brain.So,you need to be screened for high blood pressure.

Hope I have answered your query.If you have any follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review as your rating will be of help to me.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ajay Panwar (1 hour later)

THANK YOU, BUT I HAVE A FOLLOWUP. MY SPEECH HAS GOTTEN UN-UNDERSTANDABLE AFTER ABOUT NOON AND MY NEW NEUROLOGIST HAS LOWERED MY MORNING SINIMET AS I WAS TAKING 3 25MG/100MG SINIMETS AND 3 STALEVO 150MG BY 11:00 A.M. AS SHE THOUGHT THIS COULD HAVE LED TO THE PROBLEM. AT FIRST IT WORKED NOW IT IS BACK TO THE SAME. I THOUGHT MINIMAL CHRONIC MICROVASCULAR ISCHEMIC CHANGES WERE REPRESENTING MINI-STROKES AND THAT MAY BE RELATED TO THE SPEECH PROBLEM. ANY POSSIBILITY?

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
May cause speech problems.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

As I said that chronic microvascular changes are to be interpreted in light of clinical correlation.These can be non-significant but in presence of persistent focal neurological deficits,significance can be attached to them.

So,with persisting speech problems,these changes may be contributing to the pathogenesis.Antiplatelets and statins should be started.

Hope I have answered your query.If you have any follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review as your rating will be of help to me.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Prasad