Dr. Anshul Varshney
Internal Medicine
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
Hi doctor,
My mom is 55 years old. We met with a car accident. She got hit near eyebrows and so far she is on the safer side. She does not have any symptoms such as headache, paralysis, etc. Our doctor suggested a computed tomography (CT) scan of her head. In the report they found some white matter which is not clear with CT scan report. So, again doctor suggested for magnetic resonance imaging (MRI) with contrast. In the report they have mentioned that bilateral asymmetrical T2 or fluid attenuated inversion recovery (FLAIR) hyperintensities in subcortical frontoparietal and deep white matter suggesting of small vessel ischemic more than expected for the patient's stated age. Please explain the above.
Hi,
Welcome to icliniq.com. We are here to help you. This report (attachment removed to protect patient identity) is suggestive of ischemic changes. These findings are incidental and not relatedto the head injury she had. She needs to be evaluated for the possible causes like high blood pressure, diabetes and high cholesterol. I would recommend the following investigations: 1. Fasting lipid profile. 2. Echocardiogram. 3. Thyroid profile. 4. HbA1c (glycated hemoglobin). 5. Carotid Doppler.
Patient's Query
Hi doctor,
My mom does not have blood pressure (BP), diabetes and cholesterol. All these tests are taken recently when we did a complete master health checkup. Could you explain me what is ischemic change in brain and how this will affect? For my mom, kindly recommend how to avoid this disease. Do we have medicines to cure this? Is this a very serious issue to address? She does not have any symptoms and she is very normal. We are really afraid of this. Please could you explain me what to do now. Thank you.
Hi,
Welcome back to icliniq.com. As such there are no risk factors that could be the reason behind her magnetic resonance imaging (MRI) findings. However, since she has got ischemic changes, it means she is at risk of getting stroke. I would recommend, at least carotid Doppler, Hs-CRP (high sensitivity C-reactive protein) and echo, which must not have been performed in her routine evaluation. I would also recommend regular exercise and walking and also suggest having low fat diet.
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Internal Medicine
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