Get E-Book on COVID-19

Q. Does MRI with scattered white matter and hyper intensive areas indicate tension type headache?

Answered by
Dr. Sudheer Ambekar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 11, 2020

Hello doctor,

I am a 40-year-old female. I saw a neurologist after an MRI due to increasing headaches. She believes they are tension headaches, but my MRI had scattered white matter with hyperintensive areas on it. She noted that they were mild and fairly common and was not worried.

I keep seeing studies linking these hyperintensities to a three-fold higher risk of stroke even in healthier individuals with no other risk factors.

I am trying to figure out why my doctor was not worried. Is there anything you believe that my case is different than the ones in these studies? Or maybe I am missing something or maybe the doctor should be more concerned?

Dr. Sudheer Ambekar

Neuro Surgery Neurology


Welcome to

White matter hyperintensities on MRI (magnetic resonance imaging) are not uncommon and are commonly seen in many asymptomatic individuals. They are more often seen in individuals with uncontrolled hypertension.

Mere presence of white matter hyperintensities on MRI does not put anyone at a higher risk of having stroke. I understand that there are studies which may indicate so, but a causal relationship has not been proven to the extent that their mere presence should make us change or start some form of treatment. In the absence of symptoms/signs and other risk factors, the presence of white matter hyperintensities should not make us modify treatment.

Was this answer helpful?


Thank you doctor,

I would say, for a mild presentation like mine, should I do a follow up MRI after a period of time to see if they have changed? Or is it truly no concern?

Dr. Sudheer Ambekar

Neuro Surgery Neurology


Welcome back to

For an asymptomatic individual without significant risk factors for stroke, we do not usually do periodic MRI to look for a change in the white matter hyperintensities.

I believe it is of no concern unless someone has one or more of the following.

1. Neurological symptoms other than headache such as weakness or tingling of arms or legs.

2. Uncontrolled hypertension.

3. Age more than 70 years.

4. Strong family history of stroke.

5. Heart disease.

6. Uncontrolled diabetes mellitus.

Was this answer helpful?


Related Questions:
Kindly explain whether MRI brain and CSF studies show any relation to NPH.
What does the MRI brain taken for balancing issues indicate?
Is headache a side-effect of Nevanac ophthalmic suspension?

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Hypertension: Overcome the Highs

Article Overview: This article talks about hypertension, a condition in which the pressure exerted by the blood, on the walls of the arteries, is too high. Read Article

Blood pressure (BP) is the amount of pressure exerted by the flowing blood upon the walls of the arteries. The normal value is around 120/80 mmHg. Your blood pressure value is considered as hypertension when constantly there is a blood pressure of more than 140/90 mmHg. It is diagnosed by checking t...  Read Article

Hypertension - How Aware Are You?

Article Overview: This simple quiz tests your knowledge and teaches you hypertension facts. Read Article

Dr. Saumya Mittal

Please check the answer key and get to know how much you know about hypertension based on your score. 0-3: You need to learn more 3-6: A little more knowledge is good for health > 6: Keep updating yourself Question 1: Hypertensive patients should avoid exercise a) True b) False Answer:...  Read Article

Worst Headache Ever? It Could be Brain Aneurysm!!

Article Overview: A ruptured brain aneurysm is a potentially fatal condition that needs emergency care. This article helps you understand this condition and educates you regarding your treatment options. Read Article

Dr. Saurabh Joshi

This is a medical condition in which one of the arteries of the brain develops a weakened area that balloons out, like an inflated balloon. This can burst and result in bleeding within the brain. What Are the Symptoms of An Aneurysm? An unruptured aneurysm may not cause any symptoms. Some symptoms...  Read Article

Also Read

Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»
I was diagnosed with Celiac disease a year back. Can you suggest any medicine?
Having celiac fromnlast 10 year dignosis recently ayear ago since then i am gluten free still cant absorb food feeling w...  Read more»
My head is shivering from 20 days, and it feels like head trauma. What is the cause?
Hello sir, My head is shivering like anything , feeling like trauma is head. And its start anytime in a day and when s...  Read more»

Ask your health query to a doctor online?

Ask a Neurologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.