Question by Jodie: Medical help please – “Small blood vessel changes in brain (possibly due to diabetes)”?
For about a year now my husband has been having really tiny, very infrequent episodes of feeling almost dizzy, where it shifts him to the left. He went to the neuro, who scheduled an MRI, with a return visit in December (busy month).
The nurses said today that the results stated “small blood vessel changes in the brain, no sign of a stroke.”
What does this mean? Is there a name I can look up?
In particular, he is very interested in knowing any possible prognosis. Do people typically get these changes over time? or is a sign of something more sinister? Nurses there won’t answer his questions, and he really doesn’t want to have to wait a month but he is out of town even now.
That’s the short end of the story. If you want to hear his history, keep reading. I don’t know if it’s necessary or not …
History Born 12/57 to a poor family who never took him to doctors. Over the years his symptoms seemed very apparent, but doctors kept dismissing them at annual check-ups, with answers like, “You need to get off your feet.” Finally, about 5 years ago, he went to an urgent care with palpatations, where the suspicious doctor ran the appropriate tests and confirmed diabetes. Eventually ended up on the pump.
Since then, he was been diagnosed with neuropathy in his arms and legs, retinopathy, high blood pressure (under control now), and essential tremors (taking meds, not under control). He exercises incessantly and basically lives off Slim Fast and a sensible dinner.
Let me know if I need to answer any questions. I’ll be around all day, looking for comments. Thanks!
The essential tremors are not related to blood sugar. He has his blood pressure and diabetes under control. His last 90-day check-up came back as “5,” which is better than mine. (I’m healthy and 6 .)
How can he find out if the problem in the brain is serious or not? Who else can he talk to? His neuro just doesn’t seem to take him seriously. The nurse basically said there is no treatment. The neuro only took the MRI at my husband’s insistance.
Also, he exercises for about 2 hours every day, rain or shine.
Husband asking – No signs of having a stroke showed up on MRI. Would a past TIA show up as “small blood vessel changes”?

Best answer:

Answer by matador 89
Jennifer W,

Thank you for the history. There are so many causes for “small blood vessel changes in the brain” that range from serious to not so serious. Basically, alterations to the small blood vessels of the brain indicate possibilities of lesions in the subcortical structures and might lead to malfunction of any or all of the senses. These changes may be caused by hypertension – which is also known as the ‘silent killer’ because it so often has no symptoms until too late – and may indicate that this condition has been present for some time. These small blood vessel changes may also indicate lacunar infarcts which are small infarcts in the deeper parts of the brain (basal ganglia, thalamus, white matter) and in the brain stem. MRI is the scan of choice to observe these and notice if there has been any significant change to the brain structure. Most of his symptoms are often associated with diabetes. Hypoglycaemia is often the cause for tremors, and usually the tremors resolve once blood sugars are raised. However you need to discuss this with your doctor as other factors may be involved. It would appear that care needs to exercised in keeping the blood glucose/sugar steady as this is the best way to decrease the severity of diabetic neuropathies, which, unfortunately, are not reversible or curable. Likewise the blood pressure, being under medical control, should be stable. The mechanisms of diabetic neuropathy are not well understood. Pain relief medication may help and can control some associated symptoms, but the process is generally progressive. He will likely understand about exercise and diabetes and will no doubt carry out his exercise accordingly. I would expect that his forthcoming appointment in December will encompass more examinations. If there are any questions that are required to be answered, might I suggest that you have them written down on paper. Very often some questions are forgotten at the consultation and only remembered after it is over. I wish him well.

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It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms.

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Hope this helps
matador 89

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