I understand your fears and concerns. You have had some mini-strokes. You have some memory loss and confusion and some lesions around the brain. You are on aspirin to thin your blood so it doesnt clot. You are on Lipitor to lower cholesterol. You could be dealing with the problems from the strokes. Mini strokes are caused by a vessel or artery usually rupturing, and many times these are small blood vessels or small veins that rupture. The blood clots to control the bleeding which causes the blockage in the artery. This blockage in the artery, depending on its size and severity, is what deprives the brain of oxygen rich blood until the clot breaks up. If the clot didnt break up it would be considered a full blown stroke. It is called a mini stroke because the clots do break up and dissolve and the blood flow is restored rather quickly. That is good. Some do go on to have a risk of a full blown stroke but then a good percentage of people dont. You can possibly have no signs or symptoms of a mini stroke if the clot breaks up very quickly. It is still termed a mini stroke but didnt cut off enough supply long enough to cause any symptoms. There are a lot of variables here. Closed MRI's give the best pictures vs. open ones. But the films still arent that great. The radiologist can only tell you what he thinks he sees based on his training. That is why some reports "could represent" or "probably" because they just cant know 100% for sure. The best answer can be gotten by doing a conventional angiogram where a neurovascular surgeon goes up through an artery in the leg and examines your arteries and goes up to the area where the aneurysms or outpouchings (bulges in the artery) occurred and looks at the arteries and determine if that bulge has caused a weakened area in the artery and the future risk of it rupturing.This can tell you the condition of your veins and arteries and verify your diagnosis more accurately. In some cases the doctors may suggest surgery depending on the severity of the aneurysm and its relevant size. There is stenting of the artery and coiling as options. Without knowing your MRI report and what was found I cant say. I am not a doctor. I am one who was told that they had found a couple bulges on my carotid artery up in the cavernous sinus area. They are small. Only 3 mm. Not enough to stent or put a coil in. This was probably caused by a couple of small blood vessels rupturing and the clot that formed broke up very quickly because I had no signs or symptoms of a TIA. The longer the clot stays there the more symptoms you have. If the clot doesnt dissolve you have a full stroke. You are on aspirin and that will keep your blood thinned to reduce your risk of that happening. I talked to my doctor who called me and put me on a full strength aspirin to thin my blood. I have just slightly elevated cholesterol (not enough to medicate) that developed after going into menopause (this naturally happens in menopause because your hormones are linked to cholesterol levels). So I was put on fish oil to help lower the cholesterol. You might talk to your doctor about adding fish oil. It cant hurt you. I also some inflammation that was found in my bloodwork. It is unspecific as to where but I was also told that the aspirin and the fish oil both help with inflammation. After talking with the doctor and her knowing I was concerned she referred me to a neurologist to explain the MRI and where I stood. After still be concerned she sent me to a neurovascular surgeon, who is the one who actually operates and deals with the arteries and veins and operates on them and specializes in this kind of thing. He put my mind at ease about my concerns. I had had a closed MRI which give a clearer picture. But its not a perfect picture. The radiologist who reads it can only say what he thinks it is based on the picture that he sees. Mine is too small to operate on and put a stent or coil in the area. He could do a conventional angiogram to tell me the condition of my arteries. He can also tell if the carotid artery wall is thin or not. He can tell me definitively if I have an aneurysm or if the bulges are just structural defects in my artery. He can tell me if it is truly an aneurysm. But the outcome will be the same. He would only watch and wait and do repeat MRI's every year. If there was a significant change we would then move on to other options. He informed me of the risk of a conventional angiogram but reassured me that he has never had any of those risks occur with his patients. The risks are that you are exposed to radiation from the contrast material used to light up your veins while he looks at them. It can shut down your kidney(s). It has never happened to his patients. He has to tell you of the risk though. There is also a 1% chance of a stroke. He has never had this happen to his patients but he is required to assign the risk because medicine isnt perfect. They usually sedate you with Versed and Phentanyl, not general anesthesia. They thread the catheter up through an artery in our groin to the area to be looked at. The contrast material is shot in and he looks at your arteries and veins. You usually have to stay post op for about 6 hrs. to make sure that the larger artery they went in through begins healing and you are then sent home. I do not want this procedure because even if I find out my carotid artery wall is thin it will only serve to worry me and the outcome will be the same. He will only watch and wait and do repeat MRI's because its too small. Is there a chance of a future TIA? Yes. Is there a chance of full stroke? Yes. Will I have either one? No one can say. So for now, I can exhale, being reassured that the aneurysm is small and having been reassured that these usually do not change or rupture. I was reassured that I dont have to lie in bed awake at night worrying if my artery will burst. I dont have to worry that if I sneeze will it blow the artery wall. I dont have to worry that at any minute I will stroke out. I dont have to worry if I strain while having a bowel movement that I will rupture that artery. He told me to resume my normal activities and that I can get on with living. I was also reassured that my report indicating that I have microvascular disease is not a death sentence either. That statement only means that my arteries and veins are aging. He used the analogy of putting my hand next to his, and his daughters hand next to his. My arteries, because Im older than he is, are aging. He is older than his daughter, and his are aging. His daughters arteries and veins are all aging. It happens. When we are born we are aging from the onset. As we increase with age so do our arteries and veins. An 80 yr. old has worse veins than I do. Its called aging. And we are all going to do it. We all have to face that one day we will die because we age. I cant live in the "if's" of what IF I have another mini stroke? What IF I have a full stroke? I cant determine if that will happen, when that will happen. I can only live in the day and in this moment and be thankful that for today I am breathing, I can see, taste, hear, smell, touch, walk, and talk. For today is all I have and living in the day will help you to not borrow from tomorrow. And living in the past will do us no good for that is behind us. I accept the fact that when it is my time to go, (even though I am eating right, exercising, taking what I need to take in order to reduce my risks) I cannot change that but instead accept that when its my time its my time and at least I will have lived my life and basked in the joys of living and not focus on the bad that could happen. I hope you can find some peace in your situation. Acceptance is a good place to start. Maybe consulting with a neurovascular surgeon to calm your fears will do what mine did for me and allow you to move on. I wish you the best and pray for peace for you. Judy

hello::: 18 months after you wrote this, I read your post and am very grateful for every word. thank you so much.