Should I be concerned about the minor blood vessel ruptures in my head?

Joe b asked...

I recently had an MRI of the head done and when I saw the Neurologist for the results he said that there was some minor blood vessels that had ruptured. He also indicated that this was not unusual for someone my age. I am 60. Should this be a concern? Is it a warning sign of an impending stroke?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

There are a few possibilities as to what could cause such an appearance on the MRI. At the age of 60, the most likely would be that you have too high a blood pressure, and that some of the very small arteries in the brain have ruptured over the years. Another possibility would be that you have a condition known as "amyloid angiopathy" which involves an abnormal protein coating on the blood vessels in the brain. The final possibility is that you have a congenital condition of abnormal blood vessels - such as a hereditary cavernous malformation predisposition (just an example). I think it is important to clarify with your doctor which one of those is the case.

For the most part, if you have such findings on your MRI scan, it is very important for you to keep your blood pressure under very tight control. If you add the top number (systolic blood pressure) together with the bottom number (diastolic blood pressure), and add them together, you should aim for a goal of having the total be less than 200.

In addition, if you are on any blood thinners, including aspirin, I would check with your doctor to make sure that is still safe. Being on a blood thinner when you have a bleeding tendency in the brain could be potentially dangerous.

I hope that helps, and good luck!!