<s>[INST] i m 48 years old with MRI finding that says several tiny T2 hyperintense foci noted in the white matter of the frontal lobes bilaterally in keeping with minimal chronic microangiopathic ischemic white matter changes. Impression: minimal chronic microangiopathic ischemic white matter changes. Is this something to worry about? [/INST] Hi, I did review your concern. Minimal chronic microangiopathic ischemic white matter changes are seen in many people with aging. They are to be considered significant when there are accompanying neurological problems or deficits experienced by the patient like memory loss, confusion, dementia, weakness in arms or legs, speech problems, incontinence, etc. I would advise you to consult a local neurologist and show him the MRI images and report, and he will discuss in detail about these changes and their consequences. </s>