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What Does The Following MRI Report Indicate?
Question: Greetings, I recently had an MRI due to constant headaches that indicated “mild diffuse atrophy with associated small vessels ischemic changes.” I’m a 51 (male) that has taken BP medication for the past 13 years. At least for the past 15 years I’ve always had a bad ratio regarding good/bad cholesterol and high triglycerides. What does this mean? Will I eventually get dementia? Not sure what the MRI report meant by listing "MRI impression: Examination within normal limits?' Very scared and concerned…..
Brief Answer:
No reason to panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to tell you that all of us lose some brain cells every year after the twenties. Of course initially that is not visible right away but with the passing of the years as that loss is added it becomes visible on imaging exams. It is not the same in all individuals, more visible/earlier in some, less in others.
As for the small vessel ischemic changes they are also common with the passing of the years as our blood vessels like our body undergo changes and that leads to narrowing of blood vessels and less blood flow. In someone with high blood pressure and lipid abnormalities these changes tend to be more marked.
So based on the premise that we all undergo some change that "Examination within normal limits" conclusion is a good thing, because it means that these changes are within accepted normal intervals for someone your age so it doesn't mean that you will necessarily get dementia. So you shouldn't be so scared and look at the good news that there is no worrying cause for your headache like for example a brain tumor.
Now of course it would be preferable to have as little changes as possible. The best way to limit the further progression of these small vessel ischemic changes, is controlling as well as possible your high blood pressure and lipid values. That will slow their progression over the years as much as possible.
I remain at your disposal for further questions.
No reason to panic.
Detailed Answer:
I read your question carefully and I understand your concern.
First of all I would like to tell you that all of us lose some brain cells every year after the twenties. Of course initially that is not visible right away but with the passing of the years as that loss is added it becomes visible on imaging exams. It is not the same in all individuals, more visible/earlier in some, less in others.
As for the small vessel ischemic changes they are also common with the passing of the years as our blood vessels like our body undergo changes and that leads to narrowing of blood vessels and less blood flow. In someone with high blood pressure and lipid abnormalities these changes tend to be more marked.
So based on the premise that we all undergo some change that "Examination within normal limits" conclusion is a good thing, because it means that these changes are within accepted normal intervals for someone your age so it doesn't mean that you will necessarily get dementia. So you shouldn't be so scared and look at the good news that there is no worrying cause for your headache like for example a brain tumor.
Now of course it would be preferable to have as little changes as possible. The best way to limit the further progression of these small vessel ischemic changes, is controlling as well as possible your high blood pressure and lipid values. That will slow their progression over the years as much as possible.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Your response is greatly appreciated and your concern is duly noted.
I had a few questions for clarification.
In the attached report the doctors impression states towards the bottom “examination within normal limits;” does this statement also cover the sentence mentioning the “mild small vessel atrophy ischemic” for someone my age?
Since my BP is controlled, I should seek help getting my lipid values within normal limits may stop or slow the progression? What is the normal progression of this disease?
Again thank you for answering my questions and concerns.
I had a few questions for clarification.
In the attached report the doctors impression states towards the bottom “examination within normal limits;” does this statement also cover the sentence mentioning the “mild small vessel atrophy ischemic” for someone my age?
Since my BP is controlled, I should seek help getting my lipid values within normal limits may stop or slow the progression? What is the normal progression of this disease?
Again thank you for answering my questions and concerns.
Brief Answer:
Read below.
Detailed Answer:
Thank you for your feedback.
Regarding your first question, yes, from the placement of that statement and since he refers to the (whole) examination, he refers to all the findings including the mild ischemic changes.
As for the second question, some changes will be there, there's no completely stopping that, they can at times be found even in the absence of any risk factor like blood pressure, diabetes or lipid abnormalities. You should seek help getting your lipid values within normal limits, but that is only to reduce the pace of these changes, unlikely to completely stop them.
As for the future, it varies. They do confer a higher risk of cognitive function decline, stroke, parkinsonism, but that refers to averages, a higher possibility doesn't mean it will happen. Studies have shown that people with similar burden (quantity) of small vessel changes show a very wide range of clinical pictures, from the issues I mentioned to having no symptoms at all. So since you have only mild changes which are asymptomatic, there is no sense in overthinking about a somewhat increased risk in a distant future in my opinion. It's the expected risks coming with age in a large part of the population.
I hope I was able to make my point clearly and helped to make you feel somewhat better about those MRI images.
Read below.
Detailed Answer:
Thank you for your feedback.
Regarding your first question, yes, from the placement of that statement and since he refers to the (whole) examination, he refers to all the findings including the mild ischemic changes.
As for the second question, some changes will be there, there's no completely stopping that, they can at times be found even in the absence of any risk factor like blood pressure, diabetes or lipid abnormalities. You should seek help getting your lipid values within normal limits, but that is only to reduce the pace of these changes, unlikely to completely stop them.
As for the future, it varies. They do confer a higher risk of cognitive function decline, stroke, parkinsonism, but that refers to averages, a higher possibility doesn't mean it will happen. Studies have shown that people with similar burden (quantity) of small vessel changes show a very wide range of clinical pictures, from the issues I mentioned to having no symptoms at all. So since you have only mild changes which are asymptomatic, there is no sense in overthinking about a somewhat increased risk in a distant future in my opinion. It's the expected risks coming with age in a large part of the population.
I hope I was able to make my point clearly and helped to make you feel somewhat better about those MRI images.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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