Early onset cerebral small vessel disease without major risk factors?

Patient

Q: In 2007 I began to experience daily headaches. After a few weeks, I also began to experience episodes of light-headedness and some disorientation, which eveloved into a constant feeling of light-headedness. I had a CT scan of head and body: head ok but enlarged lymph nodes eventually diagnosed as lymphoma. Chemotherapy followed, lymphoma went into remission, but head did not improve. Finally had MRI scan, which showed diffuse white matter lesions. Radiologist confident this is small vessel disease. Oncologist confident it was not lymphoma-related. Never entirely convinced by this as I was 41 at the time, fit and healthy with no vascular risk factors other than high cholesterol, which my doctors knew about but did not consider warranted medication. Now on statin and asparin. Two questions: 1) is this really likely to all be due to high cholesterol, or could it be related to lymphoma, or anything else for that matter? 2) If I keep up with the medication, and lead a healthy lifestyle, what is the chance of the condition remaining stable?

Doctor

A:   The small white opacities in your brain could be due to high cholesterol and high blood pressure leading to small infarcts ( areas which dont get enough blood ) in the brain. This could also be due to the spreading of the lymphoma. However if your oncologist is pretty sure that this is not and you are not having any symptoms other than the headache, then it would point more towards your high cholesterol being the problem. Since you are on medication and also have maintained a stable and healthy lifestyle the chances of this recurring is low, however there is no specific number that can be given for the same. I wish you all the best.

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