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What Does "Few Areas Of Low Density Are Seen In The Supratentorial White" Mean?

Posted on Sat, 24 May 2014

Question: Few areas of low density are seen in the supratentorial white
matter, which are non specific but generally ascribed to chronic small vessel
ischemia. Mild generalized parenchymal volume loss and ex vacuo prominence --results of ct scan. should i be worried ?

Answered by Dr. Indu Kumar (13 minutes later)

Brief Answer:
Findings are due to hypertension,diabetes mellitus

Detailed Answer:
Hello XXXX
Thanks for writing to HCM

Few areas of low density areas in the supratentorial white matter is generally due to chronic microvascular ischemic changes resulting from involvement of small blood vessels,demyelination,post traumatic sequel etc.
In your case ischemic reason is likely due to history of hypertension,diabetes mellitus.
Chronic microvascular ischemic changes are due to ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia.
So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus and try to keep it in controlled level so that it doesn't aggravate further.
Your blood pressure is still increased,so you should try to control it.

Mild generalized parenchymal volume loss and ex vacuo prominence are age related findings and it doesn't require any treatment.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

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

Follow up: Dr. Indu Kumar (6 hours later)

My Kidney doctor did a 24 hr ambulatory bp monitor and said my bp was critically low. So he took me off the nifedipine and lisiniopril. He however explained the lisinopril was further declining my kidneys. No more blood pressure med was given to me. I know the bystolic works for that as well as lowering the heart rate.Then by my primary dr , I was recently given 10mg to start then to increase to 20 mg of Paxil , he felt this would lower the BP. This was BEFORE however the CT scan results came in. Its a bit difficult to reach the primary dr as he is a resident dr in the hosp, and the kidney dr retired, till i find a new one, was just using the primary dr. With the bp monitor , would a second test be helpful? And should i insist on seeing the doctor to get bp meds?

Answered by Dr. Indu Kumar (17 hours later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX
Thanks for writing back

Findings in CT scan brain are related to ischemic changes and these findings are generally seen in chronic patients with hypertension,diabetes mellitus and dyslipidemia.

You must had hypertension earlier.It may be normal now.
Your kidney doctor had rightly advised for holter B.P monitoring.It is very helpful in doubtful cases.
You can seek another opinion from cardiologist.You need regular follow up.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

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