Microbleed and white matter

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caat
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Microbleed and white matter

Post by caat »

Hiya, just wondering about this. I am a 61 year old woman and I know my eldest son is APOE4/4

Two years ago a MRI of my brain was made and they found white matter lesions and one microbleed.

Doctor told me that everything was great and looked good and sent me away.

But I am still wondering (and I tried to talk to him about the MRI findings but he said it was normal for my age)

Is it?


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NF52
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Re: Microbleed and white matter

Post by NF52 »

caat wrote:Hiya, just wondering about this. I am a 61 year old woman and I know my eldest son is APOE4/4

Two years ago a MRI of my brain was made and they found white matter lesions and one microbleed.

Doctor told me that everything was great and looked good and sent me away.

But I am still wondering (and I tried to talk to him about the MRI findings but he said it was normal for my age)

Is it? ...
Hi caat,

Doctors don't seen recognize that just because they tell us "don't worry", not giving us a chance to ask questions and providing us with "the big picture" means we will definitely worry! Microbleeds are one of those areas where the ability to detect them on MRIs is allowing researchers to study what they mean--but not to yet use them to predict much of anything for any one individual.

Below is an excerpt from a 2018 peer-reviewed research article by European and UK radiologists about Cerebral Microbleeds (CMBs). It includes these radiologists from the Netherlands (where I assume you live!):
  • Dr. Meike W. Vernooij ,Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam
    Dr. Joost P. A. Kuijer and Dr. Frederik Barkhof, Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam
CMBs are relatively common in aging patients without known neurologic disease, although with lower prevalence than in patients with CAA and AD. As noted previously, the actual detection rate of CMBs will depend strongly on technical factors, and also on the populations studied. Large-scale epidemiologic studies report that CMB prevalence in aging participants (age >45 years) ranges from 5% to 35% (52,55–58), partly reflecting variation in the mean age of the population and in MR imaging technique used, which is also summarized in a recent overview article (59). To mention a few of the larger population-based studies examining CMB prevalence: In the Age, Gene/Environment Susceptibility–Reykjavik Study of 1962 participants (mean age, 76 years), the incidence was 11.1% with a two-dimensional echo-planar imaging–based GRE sequence (57). The Framingham Heart Study with two-dimensional T2*-weighted GRE images (5-mm sections, 2-mm gap) estimated a prevalence of 8.8% in their population (mean age, 66.5 years) (55). In the Rotterdam study of 4759 participants (mean age, 63.8 years) with a three-dimensional T2*-weighted sequence, prevalence was 18.7%..
Cerebral Microbleeds: Imaging and Clinical Significance
If your doctor had told you that about 20% of people in Rotterdam your age had one or more microbleeds, rather than just saying "it's normal aging", you would have felt better!

For what it's worth, white matter lesions are a similar conundrum. They represent signs of vascular changes but more questions need to be answered to know the importance for any one person.

I too have a family history of strokes, coronary artery disease and congestive heart failure, ranging from a grandmother who died of a stroke in her 40's to a cousin with a recent "mild" stroke at age 71 and a mother who died of heart failure and AD at age 86 after decades of not-well-controlled high blood pressure. You may be interested in the encouraging findings of a large study of treating high blood pressure "aggressively" to get systolic blood pressure (the "top" number) at or below 120 through lifestyle and medication.
A landmark research study found that aggressive treatment of high blood pressure can reduce the risk of mild cognitive impairment. The SPRINT MIND trial (Systolic Blood Pressure Intervention Trial - Memory and Cognition in Decreased Hypertension) compared two strategies for managing hypertension in more than 9,300 cognitively health adults age 50 and older: an aggressive strategy versus a standard care strategy. At the Alzheimer's Association International Conference® 2018 and subsequently in JAMA, the research team reported a statistically significant lower rate of new cases of mild cognitive impairment (MCI) among participants receiving intensive treatment — marking the first time an intervention has ever shown a reduction in MCI in a large group of people.
Alz. Assn. SPRINT MIND

Enjoy spring in the land of tulips!
4/4 and still an optimist!
caat
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Re: Microbleed and white matter

Post by caat »

My blood pressure is magnificent and I was 59 when that MRI was made and from my mother’s site of the family everyone died of stroke or heart failure. My brother was 52 when he died in his sleep and another brother had a stroke as well. They suspected that I had a stroke as well so I was given a MRI but nothing stroke-wise came up. Only that microbleed and those lesions.

thanks for sending me information I can read although I am still worried about CAA.

I am from the Netherlands <amsterdam) and there are tulips in my garden and today it was snowing!! Waiting for Spring to begin.


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SusanJ
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Re: Microbleed and white matter

Post by SusanJ »

caat wrote:Two years ago a MRI of my brain was made and they found white matter lesions and one microbleed.
Hi caat, and welcome to the group. One tip is to do a search (that magnifying glass icon at the top right) and see what others might have posted (if you haven't already).

I see that there have already been posts on white matter lesions for example.

Take a look, and the posts might give you ideas where to go next with your research, and perhaps future lab work. Good luck!
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