What Does "chronic Whiter Matter Ischaemic Foci With A Gliotic Area" Mean?

Posted on Tue, 1 Apr 2014

Question: My mother, 60 years old is a patient of severe headaches for more than 8 years now. Her brain's MRI shows following: 1) Major intracranial flow voids are present. 2) Partially empty sella is seen. 3) A note is made of left sided mastoiditis. 4) chronic whiter matter ischaemic foci with a gliotic area in the left para-sagittal frontal lobe. What does it mean? Her headache attacks are pretty severe and last for approximately a minute or so. The situation is aggravated when the weather changes. Right now, she is taking the following medicines: 1) Prothiaden 2) Nexito Forte 3) Lithosun 4) Waklert 5) Osteovin Forte 6) Ultracet (as pain killer) 6) Indocap (as pain killer) Please suggest.

Answered by Dr. Sudhir Kumar (13 minutes later)

Brief Answer: MRI shows mild lack of blood flow to brain. Detailed Answer: Hi, Thank you for posting your query. I have noted the symptoms and MRI report of your mother. First of all, I would like to reassure you that her MRI report does not show any serious problem in the brain. The report shows that she has small areas of ischemia (lack of blood flow) of the brain. This can happen due to high BP or advancing age. She would benefit from taking aspirin tablets as a blood thinner to prevent worsening of the blood flow to brain. Other medications can be continued as at present. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/

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

Follow up: Dr. Sudhir Kumar (4 minutes later)

Dear Sir, Thanks a lot for your reply. It is indeed pretty reassuring! Her BP is actually almost always low; so I assume aging is the factor behind her condition. My only point of worry is that the headache attacks are really severe; she yells and cries during that period. It seems it is almost unbearable for her. And, during those times, she pops in 3-4 pain killers and sleep inducing medicines (as an aside, she is a pretty light sleeper and lack of sleep has also been noticed as one of the reasons of her pain) - all suggested by her doctor. She also took oral steroids (Omnicortil) for around a month last year. Is there a way to reduce such attacks? Much thanks, XXXXXXX

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer: Carbamazepine tablets would help. Detailed Answer: Hi, Thank you for getting back. It is good to note that her BP is normal. Since she has frequent and severe attacks of pain, she would benefit from taking carbamazepine (tegrital) tablets. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (12 minutes later)

Thanks again, Sir. Please also let me know if there is a probability of this condition getting any worse with age. If yes, we would want to at least be prepared. Your candid response would be deeply appreciated. Regards, XXXXXXX

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer: Unlikely to get worse. Detailed Answer: Thank you for getting back. This condition is unlikely to get worse over time. In addition to BP, blood sugar and cholesterol should be regularly checked and kept within normal limits. This would ensure that the condition does not deteriorate over time. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

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