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Doctors' Answers to "Frequently Asked Questions" - Small Blood Vessel Disease


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

General Information
Question: My father has been diagnosed as having small blood vessel disease of the brain. I have searched the web for information on this disease, but have found few references to it, and none concerning the brain. In July, my father could (and did) walk four miles and converse coherently. Last month he could get in and out of a car and walk from the car to his doctor's office. In the past few weeks he become so physically weak that he can no longer walk or even sit up unaided in bed. Also, his mental functioningís are showing marked decay. He cannot complete long sentences, deal with complex thoughts, does not know where he is, and sometimes cannot recognize my mother or myself. He has also become completely incontinent. I have been urging my brothers and sister to come visit him while he still able to recognize them, but I have no idea how rapidly this disease will advance or how long he has to live. Apparently there is no treatment for this disease. But I would like to know more about it and what our expectations should be. His doctor has been very noncommittal, perhaps to spare my mother's feelings.

Answer: Small vessel disease essentially refers to blockage of very small vessels in the brain. Breakage and leakage are also described in this way. It is differentiated from large vessel disease in that large vessels can be operated on-small vessels cannot. However, with the speed of onset I would ensure that he does not have another problem like new diabetes, urinary infection, thyroid disease,B12 deficiency or an elevated sedimentation rate. In the setting of small vessel disease, any further medical condition will give a rapid(and possibly reversible)decline.

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