<s>[INST] Hi  doctor, I am a 66 year old female with high blood pressure, having headaches (front of the head) for over a month. Recccently did an MRI and results are:Mild microvasculaar disease in periventricular deep cerebral & sub cortal white matter bilaterally.  My neurologist said not to worry about it but I am concerned.  Currently on Pamelor to help prevent headaches.  Is this a good treatment. [/INST] HelloThanks for writing to HCMMild microvascular disease in periventricular deep cerebral & sub cortical white matter are related to ischemic changes resulting from involvement of small blood vessels.Ischemic changes resulting from blood vessels changes in diseases like hypertension,diabetes mellitus,dyslipidemia.So,you need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus so that further progression of disease can be halted.You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,ultrasound of abdomen.Proper treatment depend upon findings.you should take medicines for headache.Hope i have answered your query.Take CareDr.Indu Bhushan </s>