Bright Spots on Brain MRI

Many patients bring MRIs to their appointment and ask what does it mean when the report reads “multiple foci of white matter hyperintensities.” Technically, it could mean a variety of things but if we were to discuss it on a more general level it usually indicates vessel inflammation and disease. The extent of the vessel disease is dependent upon the extent to which one sees white matter lesions on the imaging but more so on the underlying cause of the vessel disease.


The cerebral vasculature is made of different caliber size vessels and those vessels are vulnerable to inflammation. Inflammation of the vessels, referred to as vasculitis, and the diseases that cause this inflammation and its resultant effects are referred to as vasculopathies. This is different than the lesions of a demyelinating disease which will be discussed in a later post.

These diseases can be due to an autoimmune disorder such as lupus or Sjogren Syndrome, an infectious process, radiation, chronic use of drugs and medications, or certain genetic syndromes. But white matter disease on an MRI can also be due to elevated blood pressure, diabetes, migraines, depression, environmental exposures, and anxiety.


The effects of this inflammatory process can be a myriad of symptoms since it affects the brain. One can experience cognitive impairment and feel changes in their thinking, learning, or the ways in which they interact with their environment. A common complaint is mood lability, meaning a change in their emotional reactions to events and triggers. Patients often report a disproportionate emotional response while their significant other says they are “moody.” Other symptoms include depression, headache, fatigue, insomnia, and lightheadedness.


Some believe these lesions are expected as one enters their 6th or 7th decade of life. But we are not necessarily destined to suffer from cerebral vessel disease. Barring the effects of one of the chronic disorders mentioned above, we have some control over our blood pressure, our glucose levels, our stressors, our nutrition, our habits, and our outlook in life. We have the power to reduce inflammation to a large extent from the ravages of modern life and lifestyle choices.


We can choose to respect what we consume and put in our bodies. We can choose nutritionally dense anti-inflammatory meals, anti-inflammatory herbs that have been used for centuries, and supplementation with elements we cannot get from our food supply. We can choose to move each and every day to keep our muscles flexible and strong and to keep the blood flowing even against gravity up throughout our brain. We can improve our sleep hygiene habits for more rejuvenated slumber. We can stop smoking, decrease alcohol intake, and try to reduce our dependence upon medications. We can seek mental health care and treatment for things that create worry and anxiety within us.


If you or anyone you know need help in finding the way to healthier and happier aging, please do not hesitate to call our team at 206-379-1213 for a consultation.

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