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What Does " Mild To Moderate Chronic Periventricular Subcortical White Matter" Mean?
Question: My husband is 92 years old in excellent health except for severe spinal disk disease prostate problems and problems walking due to his back problems. He had is first kids fairly old; I am a lot younger than he is, and are now helping raise our grandchild with our daughter. According to his PCP he has the body of a 60 year old. No meds, no high blood pressure, etc.
He recently had a brain MRI to rule problems with a gait abnormality that is most likely due to his back. It showed age appropriate atrophy. Also showed mild to moderate chronic periventricular subcortical white matter microvascular ischemic disease. Involving both cerebral hemispheres.
Can you tell me anything about this.
He recently had a brain MRI to rule problems with a gait abnormality that is most likely due to his back. It showed age appropriate atrophy. Also showed mild to moderate chronic periventricular subcortical white matter microvascular ischemic disease. Involving both cerebral hemispheres.
Can you tell me anything about this.
Brief Answer:
Normal age related.
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your question.
In my experience, MRI findings of mild to moderate chronic periventricular subcortical white matter microvascular ischaemic disease involving both cerebral hemispheres is normal finding at this age.
The blood vessels supplying the periventricular areas (areas around ventricle) and deep cortex (sub cortical) are long and without branches. Clinically silent infarcts (no symptoms, as it does not involve large areas of brain, or there are no important areas for symptoms to show) are seen due to microvascular (small vessels) ischemia (reduced blood supply) in these areas commonly.
It involves both sides of the brain ( both cerebral hemispheres).
These are all age related vascular changes on white matter of brain. It starts usually in middle age (11-20%) and increases to 100% by the age of 90 years.
It is due to atherosclerosis and does not signify any high risk chance of stroke in future.
It is normal for this age, due to mild vascular obstruction.
Atrophy is reduced size. As the brain ages, it reduces in size due to degeneration, ischemia etc. It is normal for the age.
If you think, you require more in depth details, you can refer this study.
http://www.hindawi.com/journals/jar/2011/617927/
Hope it helps. Any further queries, happy to help again
Dr. Prakash HM
Normal age related.
Detailed Answer:
Hi,
I am Dr. Prakash HM and I would like to answer your question.
In my experience, MRI findings of mild to moderate chronic periventricular subcortical white matter microvascular ischaemic disease involving both cerebral hemispheres is normal finding at this age.
The blood vessels supplying the periventricular areas (areas around ventricle) and deep cortex (sub cortical) are long and without branches. Clinically silent infarcts (no symptoms, as it does not involve large areas of brain, or there are no important areas for symptoms to show) are seen due to microvascular (small vessels) ischemia (reduced blood supply) in these areas commonly.
It involves both sides of the brain ( both cerebral hemispheres).
These are all age related vascular changes on white matter of brain. It starts usually in middle age (11-20%) and increases to 100% by the age of 90 years.
It is due to atherosclerosis and does not signify any high risk chance of stroke in future.
It is normal for this age, due to mild vascular obstruction.
Atrophy is reduced size. As the brain ages, it reduces in size due to degeneration, ischemia etc. It is normal for the age.
If you think, you require more in depth details, you can refer this study.
http://www.hindawi.com/journals/jar/2011/617927/
Hope it helps. Any further queries, happy to help again
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you doctor this helps a great deal. I do wonder if this means he could be starting with Alzheimer's. He thinks his memory is bad I do not I think it is pretty good especially for his age. He is still driving and taking care of a 3 year old for a few hours at a time.
So you don't think could be the onset of dementia?
Thank you again.
XXXX
So you don't think could be the onset of dementia?
Thank you again.
XXXX
Brief Answer:
I do not think of dementia now
Detailed Answer:
Hi XXXXXXX
The MRI changes can be seen in dementia. But these changes alone does not signify dementia.
As a caretaker, you will have a better idea. If you don't think he has memory loss, nothing to worry. As he is able to take care of himself and surrounding people, I wouldn't think of dementia now.
In future, If you find any significant memory loss with associated decreased life style, then an evaluation for Alzheimer's can be done. Alzheimer's is clinical diagnosis based on caretaker history. There are no specific laboratory or radiological findings.
If you do not have any further clarifications, you can close the discussion and rate the answer.
If you have any further queries, do ask again.
Dr. Prakash HM.
I do not think of dementia now
Detailed Answer:
Hi XXXXXXX
The MRI changes can be seen in dementia. But these changes alone does not signify dementia.
As a caretaker, you will have a better idea. If you don't think he has memory loss, nothing to worry. As he is able to take care of himself and surrounding people, I wouldn't think of dementia now.
In future, If you find any significant memory loss with associated decreased life style, then an evaluation for Alzheimer's can be done. Alzheimer's is clinical diagnosis based on caretaker history. There are no specific laboratory or radiological findings.
If you do not have any further clarifications, you can close the discussion and rate the answer.
If you have any further queries, do ask again.
Dr. Prakash HM.
Above answer was peer-reviewed by :
Dr. Prasad
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