Will mild cerebral atrophy lead to dementia?

Q. What does an MRI finding of mild cerebral atrophy suggest?

Answered by
Dr. Prakashkumar P Bhatt
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 01, 2020

Hello doctor,

Diffusion-weighted images, ADC maps, and postcontrast sequences were also performed.


There is mild cerebral volume loss and ex vacuo dilatation of ventricular system. There are scattered punctate foci of increased signal intensity within the periventricular and deep subcortical white matter on the T2/flair sequences which are nonspecific. However, they are most likely secondary to chronic small vessel disease. There is no evidence of restricted diffusion to suggest an acute infarct, midline shift or mass effect. There are no blood products on the gradient-echo images.

Normal intracranial flow-voids are seen.

The visualized paranasal sinuses are clear.

There is no pathologic enhancement identified.

Degenerative changes are noted within the upper cervical spine.


1. No acute intracranial process.

2. Mild cerebral atrophy and mild chronic small vessel disease.

3. No pathologic enhancement identified.

What should I do and how concerned should I be? I am 70 years old and my BP and cholesterol are controlled. How concerned should I be?



Welcome to icliniq.com.

Your MRI shows mild cerebral atrophy with some small vessel disease changes. I would like to know about your memory, speech, gait and urinary symptoms. Are there any abnormalities? These changes are much common at the age of 70 but still, you have to take some precautions.

Life style modifications like regular sleep and healthy foods like low sugar, low fat, high fiber, and protein will do. Do exercise 45 minutes regularly. It is good that your BP and cholesterol are under control. Keep a watch on it. Check your blood sugar at least yearly and if raised then control it. Do regular meditation and yoga.

Thank you doctor,

I have BPH. Should I be fine? Is mild BPH normal for the age of 70? My gait, etc., are perfect. I play tennis. I do have a migraine. Prednisone and Imitrex have not reduced it. I take Cymbalta 60 mg two times a day. I have a mild persistent headache.



Welcome back to icliniq.com.

Yes, migraine is the cause of small vessel disease and mild cerebral atrophy without any memory and gait problem. Just maintain this lifestyle and regular health check-ups. We will repeat MRI (magnetic resonance imaging) after one year. For Migraine have you tried Propranolol?

Hi doctor,

Thank you so much for help.



Welcome back to icliniq.com.

You are welcome. Keep in touch for further doubts or queries.

Thank you doctor,

Is my level of small vessel disease normal for the age of 70? Can I avoid dementia and Alzheimer’s disease?



Welcome back to icliniq.com.

Yes, those small vessel changes are expected in your case because of two reasons. One is advanced age and the second is you are having migraine hence up in that condition we can see such changes in MRI.

Yes, with the above mentioned healthy lifestyle and controlled BP, sugar, cholesterol, off smoking and alcohol you can definitely delay or prevent or avoid dementia even if present in your family members.

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