Dr. K. Murali
Radiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Are deep white matter hyperintensities normal in a 40-year-old male, or are they indicative of brain damage? I was assaulted ten years back and was punched on the sides of my head, and a radiator and a door hit off the back of my head. I was diagnosed with a concussion. I had a brain CT at the time, the results of which were normal. I had the MRI before 6 years which showed deep white matter lesions. I have been suffering from persistent headaches since the attack. I only smoked for three years and was not a chain smoker. I would appreciate a response from a neuroradiologist, and I am waiting for your answer.
Hello,
Welcome to icliniq.com.
Previously we used to assume these were normal with aging, but, as of now we know these hyperintense lesions occur due to associated conditions like diabetes, hypertension, smoking, etc (the usual risk factors). So, kindly screen yourself for these abnormalities and start with appropriate control measures,if needed.
In addition, make yourself physically fit by engaging in some fitness activity. Do not worry.
If need arises your Neurologist will order for MR Angio (magnetic resonance angiography) for neck and brain vessels,
Patient's Query
Thank you doctor for the reply.
A follow-up MRI three years ago showed that the white matter hyperintensities are unchanged for almost six years. Does this prove that these white spots were likely caused by the traumatic injury I suffered previously? Gradient Echo was normal. I have not smoked for more than 18 years. I only smoked for three years intermittently. I am having migraine headaches since the attack. Is it true that migraine headaches cause white matter lesions? If so, the lesions would have increased from the previous scan, but they have remained the same. Do you see these white matter hyperintensities frequently in people who take a brain MRI as a radiologist? Are they common even in a 40-year-old male? I await your reply.
Hello,
Welcome back to icliniq.com.
Traumatic injuries can cause changes in the cerebral hemispheres, but since gradient echo is normal, it may not suggest old bleed sequelae. In people with migraines also we have seen discrete white matter changes. We see white matter changes even at 40 also.
I insist you consult with a neurologist so that he can initiate measures to control the risk factors if any.
Since the lesions are not increasing, please ignore them and lead a healthy lifestyle.
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Radiology
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