Hello doctor, I am a 53-year-old male with 6'2" height and weight 220 lbs. My HbA1c is 8.5, high triglycerides, vertigo, and some gait issues. I had a massive pulmonary embolism two years ago, not on any blood thinners, and sometimes I have high blood pressure. Contrast MRI shows a small focus of T2 prolongation present within the medial right cerebellum just posterolateral to the fourth ventricle measuring 5 mm which is also T1 hypointense and nonenhancing. This could represent sequela of an old lacunar type infarction with surrounding gliotic changes. Should I get the GGT blood test done? What is the cause of this problem?
Hello. MRI findings are compatible with an ischemic stroke in the brain. The stroke could be related to atherosclerosis and diabetes. HbA1c is high, indicative of diabetes. For this reason, I recommend physiotherapy and take daily baby Aspirin to help prevent a future stroke. It is also necessary performing a Doppler ultrasound of the carotid arteries or a carotid and vertebral artery angio CT scan. It is also essential to check your blood lipid profile. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need.