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Q. My cone CT shows calcified atheroma noted in internal arteries. What is the diagnosis?

Answered by
Dr. Kaushal Bhavsar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 16, 2022

Hi doctor,

Please see incidental findings on a recent MRI and cone CT done for trigeminal neuralgia below. What actions would you suggest based on the findings below:The incidental finding on MRI in cerebrum and cerebellum shows no mass effect. There is no diffusion restriction to suggest recent infarction. Scattered small foci of T2 hyperintense signal are present within the supratentorial white matter. These are nonspecific but likely reflects sequelae of microvascular ischemic disease the Incidental finding on cone CT shows Calcified atheromas noted in internal arteries intracranially within the circle of Willis.what is the diagnosis? Please help.

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#

Hi,

Welcome to icliniq.com.

I understand your concern.

I have gone through the report (attachment removed to protect the patient’s identity) you have attached. This report is negative for acute infarct. This report also suggests a history of small infarcts, and calcification is seen in brain arteries. This is mostly due to aging. So overall, this report is suggestive of age-related changes. Please share your age and symptoms. Please reply with answers to the questions so that I can guide you better.

I hope this helps.

Hi doctor,

Thanks for your reply.

I am 66 years old. My cholesterol level and my overall health have always been good. However, I had facial pain of late, and they have been doing tests to try and determine the cause. These were incidental findings on tests done to treat TMJ and masses. I had what I thought was dental pain, but apparently, it is nerve pain. But when I saw the incidental findings, I became a bit concerned. My doctor suggested that I should go on a tablet Statin.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I suggest you can start with a tablet Statin. Considering your age and MRI (magnetic resonance imaging) findings, I suggest a blood thinner. What about your blood pressure, sugar level, heart function, and ECG (echocardiography)? Any family history of stroke or brain disease?

Please reply to me with answers to the above-asked questions so that I can guide you better.

I hope this helps.

Hi doctor,

Thanks for your reply. I take a low dose of aspirin daily. I have since I was 40. My BP is generally low, but I do have white coat syndrome. I have tried the tablet Lisinopril in the past, but it made me cough. Also, HCTZ gives me a pretty bad headache. Blood sugars are always normal.My mother had diabetes type 1 and was a heavy smoker. She was quite thin and seemed to have many episodes of low blood sugar, and she used to have her IV glucose throughout my entire childhood. My father had been a smoker and had CHF. He had had several bypasses. My brother had a stent placed in his early 40s. EKGs are normal, but I have never had an echo. I love to walk and can easily walk 15 miles without getting tired. I was taking my A1C, which was always normal. They suddenly dropped to 4.5 repeatedly, which did not match my bs readings. My GP said it was nothing and stopped taking the A1C? My hs c-reactive protein is very good. Last year my ALP was 163 IU/L. They repeated it twice, and it came down to 137 IU/L. But exactly one year later, it went up to 163 IU/L? GGT, all other liver enzymes, and ultrasound of the upper right abdomen are normal. No one can seem to tell me why it is elevated. I am type B blood, and I am a secretor. The test was done during fasting. This is my history. Please help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I have gone through your history. No need to worry. I suggest you to continue tablet Aspirin and start tablet Statin. Continue walking and doing other activities.

I hope this helps.

Hi doctor,

Thanks for your reply. Any insight into the ALP? It is normal for me. Please help.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

Yes, no need to worry if your cholesterol level is normal.


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