Hello Thanks for writing to HCM MRI findings are due to chronic microvascular ischemic changes resulting from involvement of small blood vessels. However it is important to rule out demyelinating disease with follow up scans. 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. You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen. Proper treatment depend upon findings. Hope i have answered your query. Take Care Dr.Indu Bhushan