White Matter Hyperintensities
White matter hyperintensities are bright spots on T2 and FLAIR MRI sequences in the brain's white matter, often related to small vessel disease but with many other possible causes.
When to get help quickly: Urgent review is important with sudden new neurological symptoms — weakness, speech changes, vision loss, or balance loss — even when prior MRI showed white matter changes.
Common symptoms
Many small hyperintensities cause no symptoms. More extensive changes can be associated with cognitive decline, balance problems, or stroke-like episodes.
When imaging helps
Imaging shows the pattern, distribution, and burden of the changes — useful for separating typical age-related findings from demyelinating disease, vasculitis, or other specific conditions.
What radiology does
MRI of the brain is the standard test; the pattern and clinical context determine the next steps.
What usually happens next
Management focuses on the underlying cause — vascular risk factor control (blood pressure, diabetes, cholesterol, smoking), specific treatment for demyelinating or inflammatory conditions, and lifestyle changes.
Seen this on your report?
Your doctor or the radiologist who wrote it can tell you what it means for you.