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How do you treat chronic white matter ischemia?

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As of 2015, more research is needed to understand and treat ischemic white matter disease, according to Black, Gao and Bilbao for Stroke from the American Heart Association. Promising treatments include antioxidant compounds, sodium channel blockers and AMPA/kainate antagonists, explains Goldberg and Ransom for Stroke. Silent strokes may be a significant cause of white matter ischemia.

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The causes of white matter disease are not fully understood, but possible culprits include infarctions of the small blood vessels in the brain, occlusion of the large intracranial arteries and hypoglycemia, says Goldberg and Ransom. Experimental treatments focus on preventing white matter damage and promoting white matter healing. While research predicts a protective effect from drugs such as AMPA/kainate antagonists, research in animal models also shows certain medications may promote healing and functional recovery after strokes. Drugs such as inosine and the monoclonal antibody IN-1 enhance axon sprouting and promote functional recovery after strokes in animal models.

Research from the Krembil Neuroscience Centre in Toronto shows that tiny, silent strokes are likely an important cause of age-related white matter ischemia, notes the University Health Network. The research does not reveal whether these silent strokes are the main cause or only a minor cause of white matter disease, but it supports the preposition that doctors should aggressively treat stroke patients for risk factors such as diabetes, high cholesterol and high blood pressure.

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