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Stroke

Causes of ischemic periventricular white mat

10/10/2007

Question:

I am a 59 year-old male, with obstructive sleep apnea, mild hypertension, mild elevated LDL and mild low HDL cholesterol levels. A recent MRI of my brain showed "minimal small vessel ischemic change seen in the deep periventricular white matter tracts" Aside from the obvious need to exercise, lower blood pressure, and improve diet/cholesterol, could the observed changes be a result of low oxygen levels caused by untreated OSA? I have been using a CPAP for approx. 2 years. Would there have been improvement if this were the case?

Answer:

The "minimal small vessel ischemic change seen in the deep periventricular white matter tracts" is an extremely common finding in the MRI, especially in patients with Hypertension. Unlikely for these changes to be secondary to the OSA. However, there is a preliminary data to suggest an association between OSA and stroke (not the minimal small vessel ischemic change seen in the deep periventricular white matter tracts). Hence, it is very important to be compliant with the C-PAP machine.

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Response by:

Yousef  Mohammad, MD, MSc Yousef Mohammad, MD, MSc
Assistant Professor
Director, Stroke Fellowship Program
College of Medicine
The Ohio State University