Q. MRI report for migraine says minimal microvascular changes. What does it mean?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 29, 2018 and last reviewed on: Sep 16, 2020

Hello doctor,

I am 52 years old and had an MRI for worsening migraines for the last six months. I have had migraines for 31 years. The finding was a few foci of T2 and 3 mm T2 prolongation within the left frontal subcortical white matter. No associated restricted diffusion or abnormal enhancement. No additional parenchymal signal abnormality. The ventricles and midline structures are of normal appearance.

Impression or conclusion: Minimal left frontal chronic microvascular ischemic changes. No findings of an acute intracranial process or abnormal enhancement. What does all this mean? My neurologist said to take seizure medicine for the migraines and my brain is fine. Currently, I am taking 12.5 mg of Amitriptyline every day and Sumatriptan when needed.



Welcome to icliniq.com.

See, your MRI report is normal (attachment removed to protect patient identity) and has nothing to get worried. I would like to know a few things:

  1. Explain your headache. It is onset, severity, site. Any associated vomitings? Its frequency?
  2. How does your migraine improve?
  3. Which seizure medicine you are taking? Is it Topiramate?

Revert with the asked details for a better help.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Thank you doctor,

I am not taking the seizure medicine. I am going through perimenopause, so I think that is what is making them worse. My migraine starts very fast now, usually on right side of head over eyebrow. I have to take 100 mg of Sumatriptan and six Tylenol to stop. I used to have two in a month, and last month had 13. How is the MRI normal? Do many 52 year olds have the same findings? Does it mean I have had small strokes on the left side, and something is wrong with white matter?



Welcome back to icliniq.com.

It is unlikely to be due to ischemic changes in your brain. This looks like a migraine headache to me. Moreover, a positive response to Sumatriptan and Tynelol favors the diagnosis of a migraine. Menopause can cause precipitation of a migraine. I would recommend in such case scenario to start on tablet Flunarizine 10 mg daily at bedtime and very soon, your migraine headaches would disappear.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Was this answer helpful?


Related Questions:
MRI shows 'intermediate signal intensity lesion in endometrial cavity.' What is it?

.. report, there is a possibility of malignancy. Cancer of the uterus is more likely. Do CA 125 level, CT scan abdomen and pelvis, X-ray, sonography, PET scan and consult a gynecologist near you and also take an opinion from an oncosurgeon. Doctors...   Read full

MRI spine showed intramedullary mass at T4. Is it a cyst or malignancy?

.. you attach the MRI images and upload it so that I can see it? For more information consult a spine health specialist online --> .. ...   Read full

Are these symptoms of a menopause?

.. is right. You can have these symptoms if you are going through a menopause. As both your ovaries are removed, you are going to end up in menopause. This is called surgical menopause. To decrease the symptoms of menopause your doctor prescribed ...   Read full


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

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Also Read

COVID-19 Vaccines
A COVID-19 vaccine provides acquired immunity against the new Coronavirus. Read the article to know everything about the...  Read more»
The Perils of Social Media Addiction
Social media addiction affects both physical and mental health. Read this article to know more.  Read more»
COVID-19 - Second Wave
The second wave of COVID-19 is a red flag. Read more to know about the precautionary measures.  Read more»

Ask your health query to a doctor online?

Ask a Neurologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare 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.