Chronic Microangiopathic Disease

[chiefhouse00]

Greetings

I was in the ER last week for difficulty breathing and tension headaches. Here are the results of my CT Scan: There is no intracranial parenchymal hemorrhage, hematoma, mass, herniation, midline shift or extra-axial fluid collections. There is unchanged prominence of the CSF containing spaces and diffuse brain parenchymal atrophy with periventricular white matter hypodensities, consistent with chronic microangiopathic disease. There are atherosclerotic vascular calcifications of the intracerebral internal carotid and vertebral arteries.The calvarium is intact without fracture.

Can I submit a claim for Chronic Microangiopathic Disease?

Best Regards
Chiefhouse

[Berta]

This is the only BVA case I found with that disability claimed.

http://www.index.va.gov/search/va/view.jsp?FV=http://www.va.gov/vetapp00/files3/0021766.txt

“While the recent VA examiner determined that there is no 
medical evidence of residuals of a stroke or any significant 
degree of cerebrovascular disease, it was also opined that 
the prior MRI scan (1995) seemed to be most compatible with 
the veteran's history of underlying hypertension.  The 
physician thus implies that there is some degree of 
cerebrovascular disease, which was in fact noted on the 1995 
MRI report, and that such disease is consistent with the 
veteran's service-connected hypertension.  It is the Board's 
judgment that this opinion, when coupled with the actual 
February 1995 VA MRI report, which was interpreted as 
probably representing chronic microangiopathic disease, is 
sufficient competent medical evidence of a causal link 
between such cerebrovascular disease and the veteran's 
service-connected hypertension.  (Cerebral arteriosclerosis 
is rated under 38 C.F.R. § 4.124a, Code 8046.)” 
The decision is interesting:
“Secondary service connection for cerebrovascular disease is 
granted. 

Service connection for residuals of a cerebral vascular 
accident is denied. “ 
I am not a doctor but am familiar with MRI findings that are similar to the CT findings you posted.
Have you ever had a TIA (transcient ischemic attack) or a stroke?
Did the doctor suggest that this could stem from any service connected disability you have now 
( such as SC HBP, DMII or heart disease if you have those disabilities?)
If you claim this I certainly would claim the headaches, as secondary to it.
 

[chiefhouse00]

Happy New Years

Greetings

I have a history of micro-strokes but no major stroke at this time. I also have DMII and High Blood Pressure. Here is a copy of the MRI I had in Oct 2011.

Procedure: MRI, TIA PROTOCOL (GROUP) Exam Date: 16 Oct 2011
Comparison: Brain MRI 17 September 2009.

MRI BRAIN WITHOUT IV CONTRAST: Sagittal T1, axial T2, axial FLAIR, susceptibility weighted and axial diffusion weighted images.
FINDINGS: Polypoid T2 hyperintense lesion is seen in the posterior left maxillary sinus and measuring approximately 1.8 x 2.4 cm in axial dimensions. This has hyperintense signal on both the FLAIR and sagittal T1-weighted image this most likely related to retained mucus. Superimposed
polyp or fungal process cannot be excluded. CT scan may be beneficial and can be performed as deemed clinically appropriate. Scattered T2/FLAIR hyperintensities are noted in the bilateral periventricular white matter and are not significantly changed from the prior MRI, most likely compatible with chronic microvascular ischemic change. There is no acute infarct, hemorrhage, hydrocephalus or shift of midline structures. There is an unchanged hypointense focus in the subcutaneous tissue superficial to the right occiput compatible with scar vs remote trauma or calcification. Unchanged prominent perivascular spaces are seen predominantly in the posterior temporal and parietal lobe white matter.

MRA BRAIN and CAROTID BIFURCATION: Axial 2D time of flight images through the circle of Willis. Subtracted 3-D reconstructions are also provided. 2-D time of flight images 2 cm above and below the carotid bifurcation, with 3-D reconstructions.

FINDINGS: The distal internal carotid arteries are normal in caliber and signal intensity and give rise to normal bilateral anterior and middle cerebral arteries. The distal vertebral arteries are nearly symmetric and terminate in a normal basilar artery and posterior fossa branches. There is no aneurysm, flow-limiting disease, or evidence to suggest vascular malformation. Posterior eccentric plaque is seen in the proximal right internal carotid artery without significant stenosis. There is no significant left internal carotid stenosis. Degenerative changes of the cervical spine are incompletely imaged.
Heterogeneous marrow signal is noted within the clivus however this is stable from the prior study and of doubtful significance.

IMPRESSION:
1. Microvascular ischemic white matter change and diffuse prominence of the Virchow-Robin spaces is stable from the prior exam. No acute intracranial pathology.
2. Unremarkable MR angiogram of the circle of Willis. Mild eccentric plaque in the right internal carotid artery without significant stenosis.
3. Left maxillary sinus disease, slightly increased from the prior study.

Best Regards

Chiefhouse

Edited January 2, 2014 by chiefhouse00