Brain Atrophy & Small Vessel Disease: Causes, Symptoms, and Prevention Tips from a Neurologist

"What Are MRI White Spots? Causes, Risk Factors, and Impact on Brain Health | Neurologist Explains"

What Are MRI White Spots (Non-Specific White Matter Disease)?
Mild "non-specific white spots" seen on an MRI scan are often caused by the natural aging process. These spots, also called non-specific white matter disease, may also result from small vessel disease (subcortical white matter disease). Other terms include chronic ischemic microvascular changes, microangiopathic changes, or white matter hyperintensities (leukoaraiosis).

What Is White Matter?
The brain's white matter contains bundles of nerve fibers, appearing white due to their myelin sheath. Small, delicate blood vessels in these areas can be blocked or damaged, reducing blood supply and causing the "white spots" seen on MRI (T2/FLAIR) or dark areas on CT scans.

Severe Cases: Acute damage can lead to permanent brain cell death (infarction), known as an ischemic stroke due to small vessel disease.

Chronic Cases: Slow progression may cause dementia (vascular dementia), balance issues, depression, sleep disturbances, urinary problems, or even symptoms resembling parkinsonism.

Common Causes of MRI White Spots
*Aging
*Small Vessel Disease
*High Blood Pressure, Diabetes, High Cholesterol, Obesity. For context, 41.9% of U.S. adults were obese as of 2017 (CDC Data).
*Smoking
*Head Trauma
*Migraine (Possible Association)

Less Common Causes:
*Autoimmune Diseases: e.g., Multiple Sclerosis
*Brain Infections
*Rare Genetic Disorders

Learn More About Managing Risk Factors
Check out “My Cholesterol Guide” by the American Heart Association (Download Here).

About GEM Neurology
At GEM Neurology in Clinton, TN, we specialize in diagnosing and managing brain health conditions like small vessel disease, vascular dementia, Parkinson’s disease, and more. Dr. Luis Zayas, a triple board-certified neurologist, internist, and former physical therapist, brings over a decade of expertise in treating movement disorders, dementia, and stroke-related conditions.

GEM Neurology Services:

Comprehensive neurological evaluations
Expert care for white matter diseases and small vessel disease
Advanced treatments for movement disorders, headaches, and epilepsy
Personalized stroke management and prevention strategies
Have Questions About MRI White Spots? Schedule an Appointment!
If you have concerns about white spots on your MRI or other neurological symptoms, contact GEM Neurology to schedule a consultation.

📍 Location: 155 Frank L Diggs Drive, Clinton, TN 37716
📞 Phone: [phone]

Note: New patients are approved by Dr. Zayas prior to scheduling.

[gammagammagulch]

What a find! I had a lacunar stroke 2.5 months ago. 69 yrs., Normal wt., never smoked, lifelong fitness advocate, vegetarian. Lower Left side is numb. Getting good rehab and am working hard to walk normally. But I can’t see a neuro for 8.5 months 😢. Your video is a miracle, a gift.

[capricuba]

I was diagnosed at the age 44 with small vessel disease chronic
Thank you for the info

[cruzcoon]

I'm 38 and my MRI shows white matter and small vessel ischemic disease...and the lesions look like mini strokes?? Wth I've never had a stroke...but my mother has??I forget everything...it's frustrating when your brain doesn't work...

[pocillocortado]

Thank you for offering this valuable information. It would have helped me immensely on what to expect if i knew about SVD 11 years ago when my dad's cognitive decline began. It was relatively abrupt. In less than a month he descended into a hazy and depressed state of mind, compared to his previous diligent and brilliant personality. Both MRI and CT reported: "Old lacunar infarct in the region of the left lentiform nuclei" and "periventricular and subcortical bifrontal FLAIR hyperintensities". Years later I learn about SVD, and the functions exerted by the areas of the brain where the lacunar infarction and the hyperintensities appeared (under the basal ganglia, white matter around the ventricles and the basal forebrain), also about the clinical consequences when the circuits in those areas are interrupted.
That explained his long progressive but stepped decline, sudden dementia, depression, obsession with certain foods, apathy, incontinence, poor balance, frequent falls, etc. The neurologist diagnosed AD because of the mild atrophy in the hippocampus shown on the MRI, also because he failed miserably on cognitive tests. but I felt it was something else. Maybe he have both AD and SVD but now it doesn't matter. In the final stages of any dementia they all look the same. My dad's is too severe now and it's too late to do something about it.

[lorraineophoff]

Thank you very much for this presentation! I am in my early 70’s and have several of the factors you spoke about. I’ve been seeing a neurologist. This information was helpful!

[susanbeever]

I have T2 white spots on my brain MRI also. I had taken pseudoephedrine and did not realize that it stimulates TRPV1 that constricts microvessels called arterioles. This leads to cerebral ischemia due to too much vascular constriction that does not allow enough oxygenated blood to the brain. I had dropped foot and weak left side of my body. I took vitamin D 10, 000 i.u. 4 X/day and it stopped. Vitamin D is a partial agonist of TRPV1 and blocks complete agonists such as pseudoephedrine and capsaicin in hot peppers and other things such as acidic pH and heat. I stopped taking pseudoephedrine after realized what had happened.

[jamesdcaldeira]

Very informative doctor glad I found you and your video. I’m so sick and tired of hearing from the MRIs and CAT scans about the white matter etc. etc. it always appears to me that these doctors are too lazy to order other tests and check for further problems if you’re someone like me who has kidney disease Liver disease, diabetes high HDL triglycerides are used to be about 13.9 on the A1c and I’m now down to around 10. It’s still explosive pressure in your system. I see my doctors in Boston on Tuesday. I currently have skin cancer along with other issues and I am going to request a pet scan, so I can find out more clearly where the cancer cells may be seeing as my father died of pancreatic cancer at 68 and I am 64. My mother had a stroke has a fib she’s 87 and my brother who is 65 had a stroke at 62 my grandfather died of a heart attack at 58 years old, his wife, my grandmother on my father side again died of an aneurysm and stroke. I’m not gonna wait around to be the next one. I’ve been very proactive and I’ve got to put them up against the wall and smack them around for a while until they get the message, cause some of these doctors need a good tuneup pardon my expression thank you for the knowledge that you shared and helps people such as myself to be able to continue to run my own healthcare

[margareteid]

I think there could be a genetic link on why this can happen and also autoimmune implications are being studied right now!
I've had a small thalamic infarct stroke that i was told might be due to high blood pressure!
I also have what they called small vessel disease with mild white matter
I read a lot and found a lot of information on how it can cause cognitive decline and dementia..im hoping that I'm not going in that direction!
Your video was spot on describing what you can possibly do to prevent it..although there is a lot of clinical trials looking into inflammation and autoimmune causes for people that have healthy lifestyles but still develop white matter lesions and infarcts at a young age!
My so called small infarct stroke has left me with severe balance issues and weakness in the lower left leg and that's after 8mths and physio
These small infarcts have a tendency to be called strokes that have a good recovery..but in my case and many others that hasn't happened!

[Karmah]

I was diagnosed with SVD about 10 years ago. I have recently noticed that I am much slower in moving, my memory is being affected, my balance is off and I can't lift my left leg like I should when I walk. It is stiff and mildly drags....I can't seem to lift my toes on my left foot.
I hope this doesn't mean I will need to go into a facility soon. 🥺
ADD: I also have SLE, am prediabetic and have moderately high blood pressure, but my doctor doesn't think I need any further eval or treatment. This makes me MAD!
I do exercise regularly, but not vigorously.
When I was diagnosed with SVD, I went in because I was having chest pain and they saw part of my heart had died. They did an Atherectomy thinking I had blocked arteries, which caused a blockage to my hear, butmy large arteries were fine. That's when I was diagnosed with SMV and IHD.

[houngrysdigest]

I'm 45 and I have it. No obesity, no smoking, only had gallbladder removed and have a hard time with cholesterol and dumping syndrome.

[jilljones]

I am sorry that you did not discuss links with autoimmune diseases.

[chariotclasses-iitjeemathe]

Great video. Regards from sanjay maheshwari of India

[padmeshsethuraman]

My dad passed away in 1991 due to cerebral atrophy at the age of 69. His symptoms appeared about 2 years before he passed away.
1) he lost his memory gradually
2) he lost ability to walk.

[kathymorris]

Old age just snuck up on me. Doesn’t God have a good sense of humor. We look like cartoon characters lol🙏🏻

[morgantough]

thank you, I am terrified no one explained any of this to me . I am not old but my scan you wouldnt guess

[chickocheek]

I just have an MRI last week and its says, mild patchy periventricular and subcortucal T2 hyperintense foci in both supratentorial.
Mild cerebral volume loss with compensatory dilation of the ventricular stem .
Mild small vessel ischemic disease.
And slight narrowing after the stent i have after my brain Hemorrhage blast year but stent wis patent.

[tarawagner]

I am 51and was told I have small vessel disease. I have atherosclerosis in my brain I feel I am too young and it scares me

[MikeyIvers]

My mri shows multiple microangiopathic punctate lesions on brain . My ankles really hurt my wrists hurt my head goes numb waiting see neurologist. Nit sure if it's ms or white matter disease. The lesions are in subcortial

[tippimaravala]

Great thnx❤,
Why have u not mentioned matasis cancer which i have, reference to age that is rubbish

[randyrogers]

I was just diagnosed with cerebral small vessel disease. Unfortunately, I don't have any risk factors to work on other than age.