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Are deep white matter hyperintensities normal at 40 male?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

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.

Answered by Dr. K. Murali

Education:

MBBS

Professional Bio:

Dr. K. Murali is a leading Interventional Radiologist known for his expertise in minimally invasive, image-guided procedures. With a strong commitment to precision and patient safety, he specializes in advanced diagnostic and therapeutic techniques. He is dedicated to delivering high-quality care, improving outcomes, and reducing recovery times through innovative, non-surgical treatments tailored to each patient’s needs.

This doctor is not available for online consultations on the platform anymore.

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.

I hope this answers your query.

Thank you.

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.

Answered by Dr. K. Murali

Education:

MBBS

Professional Bio:

Dr. K. Murali is a leading Interventional Radiologist known for his expertise in minimally invasive, image-guided procedures. With a strong commitment to precision and patient safety, he specializes in advanced diagnostic and therapeutic techniques. He is dedicated to delivering high-quality care, improving outcomes, and reducing recovery times through innovative, non-surgical treatments tailored to each patient’s needs.

This doctor is not available for online consultations on the platform anymore.

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.

I hope this answers your query. Thank you.

Answered by Dr. K. Murali
Medically reviewed by iCliniq medical review team
Published At May 3, 2021
Reviewed At August 8, 2025

Education:

MBBS

Professional Bio:

Dr. K. Murali is a leading Interventional Radiologist known for his expertise in minimally invasive, image-guided procedures. With a strong commitment to precision and patient safety, he specializes in advanced diagnostic and therapeutic techniques. He is dedicated to delivering high-quality care, improving outcomes, and reducing recovery times through innovative, non-surgical treatments tailored to each patient’s needs.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Education:

MBBS

Professional Bio:

Dr. K. Murali is a leading Interventional Radiologist known for his expertise in minimally invasive, image-guided procedures. With a strong commitment to precision and patient safety, he specializes in advanced diagnostic and therapeutic techniques. He is dedicated to delivering high-quality care, improving outcomes, and reducing recovery times through innovative, non-surgical treatments tailored to each patient’s needs.

This doctor is not available for online consultations on the platform anymore.

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