Greetings, Dr. Roach The skin beneath my left eye was split by a recent fall. To find out if sutures were necessary, I went to the emergency room. They requested an MRI after I complained of a headache on the left side of my head, which revealed mild small vessel ischemic disease and atherosclerotic vascular disease. Additionally, they discovered plaque in my interior carotid arteries.
I should see a vascular specialist shortly, the emergency room doctors advised. I’m afraid, of course. I am a 76-year-old woman taking thyroid replacement, benazepril, rosuvastatin, and bystolic. Sulfasalazine is another medication I take for inflammatory arthritis. I workout four times a week, take a lot of vitamins and supplements, and maintain a trim figure. Does an MRI indicate Alzheimer’s or dementia? What does it signify? — R.M.
ANSWER: No, dementia cannot be diagnosed by MRI. A provisional diagnosis of dementia is made during a clinical examination that identifies deficits in cognitive abilities like memory, language, and attention. (A pathological assessment of brain tissue, which is rarely done while a person is still living, is necessary to make a conclusive diagnosis of Alzheimer’s.)
The MRI reveals that cholesterol plaque has created a disorder of the brain’s blood vessels. People are susceptible to this disorder due to a number of variables, including smoking, high blood pressure, high blood cholesterol, and family history. Dementia, which is brought on by repeated little strokes that produce cumulative damage to the brain tissue, affects some but not all persons with the types of blood vessel illness you have. Both the tiny and large veins (carotids) are impacted in your situation, which indicates that your blood pressure and cholesterol haven’t been at their best.
To halt or stop this problem from getting worse, your doctor has already taken some action. It’s crucial to carefully manage your blood pressure using benazepril and bystolic. Rosuvastatin, a statin medication, has been demonstrated to lower the risk of stroke and dementia in general. Since only your doctor knows you well enough, I cannot say whether these medications are the best for you or whether the dosages are appropriate, but it is obvious that your doctor is taking precautions to safeguard your heart and brain.
Early therapy is more crucial for individuals with inflammatory arthritis, particularly lupus and rheumatoid arthritis, as these illnesses raise the risk of blood vessel damage in the heart and brain. Regretfully, not all primary care physicians are aware of the significance of inflammatory arthritis in relation to the risk of heart attacks and strokes.
Although there are a few individuals who might benefit from them, I do not think there are any vitamins or supplements that are both safe and effective at preventing stroke in general. For instance, vitamins B12, folic acid, or their methylated counterparts may be beneficial for those with elevated blood homocysteine.
It’s crucial to carefully examine your diet and general wellness. If there is any indication that your capacity to think has changed, you can be referred to a specialist for cognitive testing. You can further stratify your risk with a few blood tests, which may indicate that you require further treatment.
More advice
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Miss Manners: Why should I care about the comfort of the person sitting behind me on a plane?
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Asking Eric: Is grandma trying to be funny when she tells her children she loves the new baby better than them?
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Dear Abby: Was it legal for my meddlesome mother-in-law to take out a life insurance policy on me?
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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