What is vessel disease

She also is on cholesterol tablets. My mums mobility has never been great she is really slow and very nervous with steps etc. My mum has also reported feeling down lately could this be the vessels too.

Vertigo the false perception of spinning or tilting is fairly common among older adults, but can be due to a number of different causes. It is possible for vertigo to be related to problems with blood circulation in the brain. This is called vertebrobasilar insufficiency: Pathophysiology and Diagnosis of Vertebrobasilar Insufficiency: A Review of the Literature.

Are they talking about reduced circulation in the larger or medium sized arteries? Or are they referring to cerebral small vessel disease? Many people do improve with a special form of therapy called vestibular rehabilitation. Last but not least, if your mother is feeling down, then I would recommend further evaluation for depression. If she is feeling well, I would recommend discussing the findings with her doctor and asking for help identifying and managing any risk factors for cerebral small vessel disease.

I am female, 67, with a history of controlled hypertension. I am prepared for a good discussion with my primary physician next month when I have my annual physical. Again, thank you for your clear explanations. When you see your doctor, you may want to review your blood pressure treatment plan. K I am a 46 year old with mild small vessel ischemic disease, history of having silent strokes also.

I get dizzy drop things. Out of all the causes I dont have any except I am a smoker and family history of strokes and heart attacks.

My question is how can or what do I need to do to slow this down. First is stop smoking and started that with chantx. Diet, natural herbs, vitamins? Thank you for your article also. Stopping smoking is an excellent and very important start. Otherwise, I recommend you work in person with a good doctor, to get help determining which are your particular stroke risk factors and how they can be managed.

For instance, are you quite sure that your blood pressure, cholesterol, blood sugar, and inflammation levels are low? Especially if there is a family history of stroke or heart attacks, a careful evaluation of your health might reveal some risk factors that could be treated. Taking specific vitamins or herbs is probably less helpful than overall eating a healthier Mediterranean-style diet , by which I mean one with a lot of vegetables, fruit, and fiber, minimal junk food or processed foods, and not too much red meat.

You may want to start by focussing on staying off tobacco, exercising more, and eating better. That in of itself often improves a lot of the other cardiovascular risk factors. I have severe stenosis of the neck but No other risk factors of stroke. I recently had a stroke in the cerebellum that the have no identifying cause for. No hydrocephalus. No mass, mass effect or midline shift. Basilar cisterns are patent. No acute ischemic infarct. Very small left inferior cerebellar lesion corresponding to previous infarct, though smaller in volume than the ischemic insult seen on original exam.

Few nonspecific punctate foci of white matter T2 prolongation, likely reflecting sequela of chronic microvascular disease. Orbits are unremarkable. No acute calvarial abnormality.

Extrarenal soft tissues and paranasal sinuses are unremarkable. There is normal opacification of the posterior circulation via the right vertebral artery. The bilateral internal carotid arteries are normal in caliber and course. Visualized Circle of Willis is unremarkable. I have constant vertigo 3 to 4 times a day could the stenosis be compressing the left artery and causing this??

Sorry to hear of your health problems. I would recommend asking a neurologist, preferably one with experience managing these types of posterior circulation problems.

You might also want to ask the neurologist if your vertigo seems to be due to central causes or peripheral causes. I share some more information about vertigo and its evaluation in this comment above. Good luck and I hope you find some answers soon! Today my father took a brain MRI and received a referral like the one below. In , I was told that the stroke was recovering with a small stroke. No evidence of focal hemorrhagic foci or mass lesion in brain parenchyma.

No demonstrable widening of cisternal and ventricular system. No demonstrable mass effect. Otherwise unremarkable. Conc 1. Arachnoid cyst, posterior cranial fossa. Chronic ischemic change, both periventricular white matter. You may want to ask your health providers if it appears to be mild, moderate, or severe in extent.

A study published in found that such cysts often tend to remain stable in size, with no new or worsening of symptoms. Prevalence and natural history of arachnoid cysts in adults. You may also want to ask how the findings compare with whatever head imaging he had in , when he was diagnosed with the small stroke. My husband has developed mild cognitive problems primarily visuospatial during the last year.

He is seeing an psychiatrist who has not made a definite dx at present. He maintains a healthy diet, has excellent blood pressure, healthy weight and takes Aggrenox , crestor and Carvedilol. He had what was possibly a TIA last year with no residual. His MRI showed mild white matter T2 hyperintensities consistent with Chronic Small vessel ischemic changes expected for age. He also had a Carotid bilateral which showed a moderate amount of plaque.

The MRI was repeated and showed minimum periventricular and brainstem chronic small vessel ischemic disease. Should he see a neurologist? Is it possible that the carotid artery problem could have caused the CSVD? Should we continue with testing for dementia or should we turn our attention to testing for the cause of the CSVD? What medications are effective for vascular dementia when a patient has depression and anxiety?

If he is 84 and has a history of coronary artery disease, then I think an extensive workup for causes of cerebral small vessel disease is unlikely to be fruitful. Presumably he is getting good medical management to reduce his risk of future cardiovascular events; you say his cholesterol and BP are under good control, and he is taking an anti-platelet agent. There are other aspects he could consider, but honestly the older people are, the less effect those approaches seem to have on preserving cognition.

I list things that help optimize brain function whether or not one has a dementia diagnosis here: How to Promote Brain Health. You should know that as people get into their 80s and beyond, it becomes extremely common for them to have multiple underlying causes of cognitive impairment.

This has been shown in autopsy studies. But regardless of the underlying cause, the mainstay of optimizing people is to minimize the things that make them worse, and otherwise help them with whatever is hardest or most challenging for them.

This information is a follow-up from my message on and your response on I really appreciate the help you provide. It is invaluable to so many who are desperately going through a difficult time. I will be going to an appointment Psychiatry with my 82 year old husband in 2 days. He has taken Zoloft, Xanax, Trazodone previously with side effects of disorientation, increased confusion.

What do you think of the C-Reactive protein tests? I noticed the material indicated that if the impairment is not due to neurodegeneration it often remains stable and can improve.

I realize this would be expecting too much with CVD. Is there a possibility that the carotid artery blockage could cause restriction of the blood flow to the brain resulting in ischemia?

If so, it would not be resolved and continue to cause critical problems. I question whether to see a Neurologist concerning this problem.

His Carotid test shows moderate blockage. He had leg weakness at the time. Thank you for what you do. Susan Stewart. I address C-reactive protein in my recently published article on cardiovascular risk factors. I would definitely recommend regular exercise and getting outside regularly, and I cover some other important lifestyle approaches in the article on cardiovascular risk factors.

SSRI-type antidepressants may help some people with cognitive symptoms, although the research is mixed. The others tend to have more interactions or problematic side-effects, especially paroxetine Paxil , which is anticholinergic. The right kind of oversight lifestyle factors plus avoiding medications that dampen brain function can help people have the best brain function possible, but cannot make them entirely as they used to be.

I see a lot of families neglect to take care of themselves and learn to better manage cognitive changes, because they are so caught up in the medical details. Good luck and take care. I have read all the comments here and have noticed a large number of women with this issue who are also in the peri-menopausal to newly menopausal age range. Hormones are a vastly understudied and misunderstood factor in so many things in our lives.

My health was tipped upside down as my hormones diminished, and I have gotten some of my well-being back by restoring my levels. What is your opinion on them regarding brain health and CSVD? I took a quick look in the literature and there does yet seem to be much known about how sex hormones affect the health and function of small blood vessels in the brain, but research is ongoing.

But presumably whatever seems most effective at minimizing cardiovascular risk factors should help. Your statement is both true and tragic.

There are billions of women on this planet, and more and more of us are making it to menopause and beyond, yet so little is known about cardiovascular diseases and their relationships to our hormones.

Heart disease and related conditions affect such a profound proportion of us, killing five times as many of us as breast cancer, and yet we are only now beginning to ask the important questions and do the research. The WHI study that came out in painted all hormone replacement as bad, and as a result, doctors around the world pulled woman off HRT in droves. Yet now we know that the study was deeply flawed. People should have asked long ago why it was that the female hormones that protected us so well from cardiovascular disease early on, suddenly turned on us in later years.

That defied logic on every level. Anyway, women across the board are understudied, under diagnosed, and under treated when it comes to heart disease. In the past, researchers did not want to study us because our hormones complicated things and added too many parameters. But it is time now for everyone to get with the program. I was diagnosed with CSVD just last week, and I would really like to know what hormones can do to possibly slow this progression.

The clock is ticking. Agree, women have historically been inadequately studied in medicine and we are far behind where we should be. Thank you for this excellent information. I do need to think more like a geriatrician both for myself and my aging patients. Keep writing, please! I so appreciate all the information you are providing! My partner is a 64 year old female. She was a very well respeced national educator. Mentally quick and very social.

For the last 4 yeasrs she has been having problems with visual spatial, language and executive function. She is depressed and no longer able to work or drive because of this.

I am her care taker. Her recent MRI says she has moderate generalized volume loss and White Matter disease — probably on basis of small vessel disease that has progressed since last MRI 3 years ago.

There is a 1. As a child she had many xray treatments on her birth mark located on right temple and eye. Trying to figure out what is causing her cognitive problems. Her Thyroid, blood sugar, blood pressure and Cholesterol are all in normal range. None smoker. Used to be very active and work out every day. Now take only short walks. Rather stay home. Mother had early onset Alzheimers. Wondering if the small vessel disease and the mass on the temporal bone could be the cause.

We have had no help from primary doctor. The Alzheimer doctor she saw 3 years ago said not MCI. The stress of trying to find out what is causing all this has become very stressful for me.

Any thoughts would be appreciated. It sounds like she saw a specialist three years ago but in three years a lot of things can change, and it sounds like her symptoms are much more significant.

I am not a neurologist so not very well positioned to say what impact her tumor might have. It does sound small to be causing all the symptoms you describe. Interesting read. I have been doing a lot of my own research because I am one who wants to know answers, even if there is no cure.

She is 94 years old. At that time, she was having issues finding the right words and was frustrated. She has always been active, so it is hard to see her decline so quickly. Since , her aphasia has progressed to where most of what she says is hard to understand. Her last known stroke was in She has been on Plavix since after a heart attack.

She does have gait issues and does lose her balance and falls quite often. That sounds like SVD is the cause. She has not been diagnosed with dementia. She does get confused at times, though.

She appears to know what it going on. But, with her aphasia, it is hard to say if she is just saying the wrong things… Would SVD lead to aphasia?

I would like to know what we can expect with her continued decline. We have in-home hospice care. Mom is still mobile, but needs personal care assistance. Hospice lists her terminal illness as aphasia. Seems odd to me…. Small strokes and other forms of vascular damage to the brain could certainly cause or worsen aphasia.

Problems with balance and falls are almost always multifactorial in people her age. Most likely SVD is a factor but she also probably has other issues that are common causes or contributors, such as low leg strength. Honestly, you can try to research the whys, but ultimately it tends to be most productive to focus on identifying issues that can perhaps be corrected or better managed, such as medication side-effects.

The other thing that is often important at this stage is to think of quality of life and do what you can to help her enjoy whatever time she has left. Of course, walking better might improve her quality of life, but is it worth pushing her to do physical therapy or some strengthening exercises at this point? There is no exact right answer, generally what is best is for patients and families to get their doctors to help them weigh the likely benefits and burdens of your available options.

If she is on hospice, they should be able to tell you more about what her recent decline might mean, and what to expect. Try to treasure the time you have with her now. It is normal to worry, and also to feel grief. Be sure to find some support for yourself. Finding a way to come to terms with the uncertainty is one of the hardest things about this time. Age 75 with having hemorratic stroke at age Did well with physical therphy.

Five years ago had diszzness, trouble with balance and was hospitalized. Told I had Microvasular ishemic disease after MRi. I have diabieies but blood pressure is under control as is my blood sugar most of the time.

Recently have been having some dizziness again, fatigue and more depression. Could my DVT be getting worse or is it only age related. Starting over with new Physician as long time Physician has recently retired. I enjoy your blog so informative. Sorry to hear of your recent symptoms. That said, there are LOTS of other causes for such symptoms in people aged 75, so I would highly recommend that you ask your new physician to carefully evaluate you for your dizziness, fatigue, and mood.

Good luck with your new physician, I hope you get a careful evaluation and some helpful guidance. I am 69 years old. I do not have diabetes, high blood pressure, am not overweight and have never smoked. My cholesterol is higher than normal. I had breast cancer treatment 7years ago, including chemotherapy and hormone inhibitors. After 2 years, I still had brain fog, headache, and balance problems. A MRI showed svd t no recommendations or treatment. Now, after 7 years, I am still having same symptoms.

Another MRI did not show significant difference in past 5 years. Since svd was not shown on MRI done prior to chemo, I wondered if chemo could be a factor? Neurologist could only recommend diet and exercise since I do not have common risk factors. I would encourage you to keep asking your clinicians to help you evaluate and manage your symptoms.

For instance, special exercises to improve balance work for a variety of older adults with balance difficulties. Similarly, there are special therapy programs that often help people experience less pain. I am curious about my situation. I have suffered from mild to moderate tremors for a while.

Was sent for scans at the hospital which I was told showed nothing. I suffer from dizzy spells as well. My curiosity is because I got a hold of my diagnostic list from the doctors and on the form it states. Ruled out evidence of stroke. Some minor changes in the posterior horn of the lateral ventricle, representint small volume small vessel microangiopathy — atherosclerotic disease. Yes, this is the same as cerebral small vessel disease.

You can ask your healthcare providers to clarify whether it appears to be mild or more significant. As I note in the some of the comments above, some people do show signs of this when they are in their 40s or 50s. I am 75 WI and my brother is 65 OH.

We both wake up in the morning with a headache that starts in the back of the neck and sometimes radiates to the the temples. My brothers are much more severe than mine and can be non functioning pain for him.

He has tried a lot of different medications with little relief. Mine did come back as fairly normal for my age per my doctor with: 1 Moderate SV chronic ischemic disease 2. Focus magnetic susceptibility left cerebellar hemisphere, sequelae are of remote hemorrhage. My physician discussed and told me the results are normal for a 75 year old male. Yet I continue to get the headaches every morning as I awake.

Mine usually get better as the day progresses. My doctor says they are stress related. I am a type A person so I respected his conclusion until:. He has since been referred to another neurologist for further evaluation. Is this some condition that could be hereditary? My headaches seem to be getting much worse and more frequent.

I did have one lately that lasted through the day for 6 days straight. This prompted the MRI. But still have these headaches. Have tried massage therapy and chiropractor with little relief.

Would like to have your thoughts since your blog is the best I found on SVD. Plus, of course, I would like to know why we both get these headaches when we awake in the morning. Thank you in advance for your input. I see my doctor again on Monday Mar 5th.

There are specialists in headaches generally neurologists and there are specialists in stroke and neurovascular issues also neurologists. Either type would be far better suited to address your concerns than I — an internist and geriatrician — can be. My guess is that consulting with a headache specialist is more likely to be productive.

There are a number of different issues that could be causing your morning headaches. Just by taking a quick look in my clinical references, I see that sleep apnea can be associated with headache. It is also possible to get headaches related to irritation of the cervical nerves that innervate the scalp. These are sometimes called cervicogenic headaches. Such irritation can sometimes be caused by arthritis in cervical part of the spine. There are undoubtedly other potential causes to consider for your headaches.

Otherwise, your SVD does sound common for your age. Given the remote hemorrhage in your cerebellum, it would be reasonable to pay attention to your risk factors for stroke and cardiovascular disease, as you are probably already doing. Vascular issues mentioned, Neuro app months away.

GP read MRI report, ordered bloods etc slightly raised cholesterol borderline. Your GP should be able to discuss the likely benefits and risks of statins for your situation. Generally they are well-tolerated. With the right side of my head brain experiencing pain.. Is there medication for this and should i get an MRI to make sure that its not something else?

If you are having a new pain in your head or elsewhere, you need to start by seeing your health provider or another clinician, for a more in-depth interview and physical exam. Lots of different things can cause pain. Then the clinician should be able to advise you regarding which medication might help, and can formulate an opinion as to whether there is an indication for getting an MRI. I have a question for you. This is the result from my husband 62 years old MRI report done Oct.

There is mild enlargement ventricular system and subarachnoid spaces with mild to moderate periventricular and subcortical white matter gliosis. There is no restricted diffusion or mass effect. The craniocervical junction is normal. The flow voids of the major intracranial vascular structures are grossly normal. Extracranial soft tissues are normal. Impression: Mild atrophy and chronic small vessel ischemic changes without evidence of an acute abnormality.

His PCP informed him that it is normal, no mini strokes, while the neurologist states he has had several mini strokes. We are of course going with what the neuro says. But why would we get two different opinions?

He is having a lot of balance and falling issues. He is diabetic severely , no high blood pressure, does have high cholesterol.

Sorry for the confusion and good luck! It also says moderate cerebellar atrophy with ex vacuo dialation of the fourt ventricle. Any clarification on these findings would be helpful until I see my primary in a couple of weeks.

I would definitely recommend asking a lot of questions once you do get a chance to see your doctor or another specialist. Be sure they explain what might be going on with your brain, what their plan is for further evaluation if any , and what they recommend, to help you maintain your brain as best you can. I just received MRI with contrast report which says there is no suspicious intraparenchymal, leptomeningldeal, or dural based enhancement.

Than it says: this is suspected to reflect the sequela of chronic microangiopathic disease. I appreciate your advise very much. Sorry for your headaches and recent health concerns. Prognosis and what to do really depends on what is the cause of the problem.

Can living at high altitude ft past 4 years-sea level prior to that cause or contribute to chronic microvascular ischemia of the brain? Night time hypoxia requiring O2 for sleep. Otherwise: concussions, inflammation, these are all things that could aggravate or damage small blood vessels in the brain. My husband, now 73 was diagnosed with vascular dementia early stages 2 years ago. Since then he had been quite stable. He has recently been in hospital following a chest infection.

An MRI showed small vessel disease. Mentally, he is pretty much the same as before hospitalisation. Not sure what you mean by prognosis, do you mean his life-expectancy or more generally what to expect in the future? I would recommend you ask his usual doctors for more information as to his prognosis and what to expect. In general, people with dementia tend to get worse over time.

A local or online dementia support group can be very helpful in thinking these kinds of things through. I am I first had difficulty starting in with fatigue, fibromyalgia, difficulty finding words and mild depression. MRI showed large amt. I saw a neurologist for awhile, and also had psychometric tests.

They showed a decline over a few years of sequencing. I also received counseling. I had depression caused PTSD. I think because of the recent decline I should be rechecked. I take cholesterol meds, 4 different antidepressants, flexeril, tramadol, Nortriptyline and Ambien at night.

Occasionally I take an extra tramadol and or flexural in the daytime. I take up to 4 tablets of Naprosyn a day. I use 8 hour hot packs on my neck frequently and have had wrist, elbow and heel tendonitis on occasion with PT to reduce symptoms. I returned to playing water-volleyball this past week. I have been doing this since shortly after my MS diagnosis. It is hard to get there on time. I would like arrive earlier to do water aerobics but seldom do.

I am avoiding stress as much as possible during this busy time. Your medical history sounds exceptionally complicated. If you have noticed recent declines, then getting re-evaluated or getting a second opinion certainly sounds reasonable.

If you have noticed any difficulties or declines in memory or thinking abilities, then you may want to discuss your medications in more detail with your doctors. I am 63 and recently had a severe headache in the back of my head that lasted for about seconds and was associated with orgasm.

Never had it before. Impression: 1 no acute intracranial pathology 2 mild volume loss and mild chronic small vessel ischemic disease. I work full time, have never been overweight, have never had HTN, take no medicine except vitamins. No headaches, migraines etc. Your thoughts? Is this really considered normal? My understanding is that researchers are still trying to sort this out.

A study published in did find that inflammation is associated with brain volume changes later in life: Midlife systemic inflammatory markers are associated with late-life brain volume. There is some evidence that our typical modern lifestyle sub-optimal diet, stressful lives, not enough sleep, etc contributes significantly to chronic inflammation and that this results in more wear on the body and brain.

If you have questions about your MRI findings, you should discuss them with your doctor. You may also want to consider getting a second opinion from a doctor with experience in neuroradiology. I have a history of high cholesterol and was at one time borderline diabetic but have that under control now.

I am overweight but working to turn that around with diet and excercise. She already has me on a cholesterol medication and advised I start taking a daily baby aspirin. Just wander what your take on this is? My understanding is that research is still ongoing, regarding the role of aspirin in managing people with signs of cerebral small vessel disease. For people who have never had an event, aspirin can be considered for those who seem to be at particularly high risk.

You may want to ask your doctor to clarify how she is calculating your risk for cardiovascular disease in general. There are well known calculators that can be used online. Otherwise, my related article on addressing cardiovascular risk factors. You might experience these symptoms after routine daily activity or times of stress. Typical chest pain from this condition can last anywhere from 11—30 minutes or more.

If your symptoms get worse, or you experience pain beyond your chest, call your doctor immediately. Small vessel disease occurs when the inside walls of the small vessels in your heart are damaged, affecting their ability to be able to properly dilate. If left untreated, small vessel disease will force your heart to work harder to pump blood to your body. Anyone can develop small vessel disease, but women are at more risk.

Diagnosing small vessel disease can be difficult. Your doctor will have to evaluate your medical history, family history, and symptoms. Diagnostic imaging procedures for small vessel disease are typically the same as those looking for other types of heart disease.

These procedures show the structure or function of your larger coronary arteries and other parts of the heart, and may show coronary artery blockages. These tests may include:. If there are no significant blockages in your larger coronary arteries, doctors will use an invasive test, injecting different medications into a coronary artery, to check for blockages in your small arteries during a left heart catheterization.

This is called an endothelial dysfunction test. This allows the doctor to measure the blood flow through your small vessels. Primary treatment options for small vessel disease involve medications that relieve pain, treat risk factors, and control associated symptoms. These medications will improve arterial blood flow and prevent heart attacks. Per the American Heart Association , specific studies on how to prevent small vessel disease have not been done.

However, lifestyle changes and a healthy diet can reduce your risk of developing heart disease. Show references Coronary heart disease. National Heart, Lung, and Blood Institute.

Accessed June 14, Chaudhary I. Microvascular angina: Angina pectoris with normal coronary arteries. Selke FW, et al. Coronary artery endothelial dysfunction: Basic concepts. Ahmed B, et al. Alternative causes of myocardial ischemia in women: An update on spontaneous coronary artery dissection, vasospastic angina and coronary microvascular dysfunction.

Vascular Medicine. Kaski JC, et al. Reappraisal of ischemic heart disease. Ong P, et al. International standardization of diagnostic criteria for vascular angina. International Journal of Cardiology. Hoffmann U, et al. Cardiac imaging with computed tomography and magnetic resonance in the adult. Coronary microvascular disease. American Heart Association. Epicardial coronary spasm in women with angina pectoris and unobstructed coronary arteries is linked with a positive family history: An observational study.