White matter, located deep within the brain, consists of nerve axons connecting different brain regions and the brain to the spinal cord. These fibers are encased in a myelin sheath, which ensures stable nerve impulse transmission and supports functions such as movement, memory, language, and emotion.

Master of Science, Doctor Nguyen Thi Hai Yen, of the Department of Neurology and Stroke at Tam Anh Cau Giay General Clinic, notes that white matter lesions can result from aging or underlying medical conditions. Aging-related white matter lesions, often benign, commonly affect older individuals. They are typically mild, progress slowly, and may not present with clear symptoms, considered a part of the brain's natural aging process.

Pathological white matter lesions are often associated with small vessel cerebral disease, which develops when the brain's small blood vessel system sustains damage, reducing blood flow to brain tissue. This condition typically affects individuals with cardiovascular risk factors, including high blood pressure, diabetes, dyslipidemia, or a history of smoking.

In early stages, patients may not exhibit clear symptoms. As lesions advance, individuals may experience memory decline, difficulty concentrating, slowed reactions, unsteady gait, frequent dizziness, or balance issues. Some also report emotional changes such as anxiety or sadness. Due to their gradual onset, these symptoms are often mistaken for normal aging.

A patient undergoing a brain magnetic resonance imaging (MRI) scan to diagnose white matter lesions. *Illustration: Tam Anh General Hospital*

Diagnosis of this condition primarily relies on brain MRI scans. Doctors assess lesion severity based on the number, location, and spread of abnormal areas. More severe white matter lesions correlate with a higher risk of cognitive decline, vascular dementia, and stroke.

Pathological white matter lesions can lead to multiple complications, including cognitive decline, which impairs memory, information processing ability, and independent daily living. Patients often experience an unsteady gait, taking short, slow steps, making them prone to falls. Furthermore, pathological white matter degeneration can trigger emotional disorders, contributing to depression and anxiety.

Doctor Hai Yen emphasizes that not all white matter lesions visible on MRI scans are dangerous. Lesions attributed to aging factors are generally not a cause for concern. Patients should consult a specialist for monitoring and a thorough evaluation to accurately determine the nature of their lesions.

Additionally, effective management of blood pressure, blood sugar, and blood lipids, combined with regular physical activity, abstaining from smoking and alcohol, and consistent follow-up appointments, can help slow the progression of white matter lesions and mitigate complication risks.

Hieu Nguyen