What you could be having may be related to blood pressure, high cholesterol, some other autoimmune or inflammatory condition, or it could be a false finding on the MRI. MRI is a very sensitive technique to detect these changes which can mean that some findings are not really there (know as false positives). Microvascular changes in the brain can cause disruptions in blood flow to the brain. These can result in tiny strokes which can have detrimental effects on the nervous system. The good news is that you don't appear to have any sign of damage to you brain. The headaches you are having are not likely caused by these microvascular changes. It is also possible that you are having migraine
headaches which are causing changes on you MRI that look like microvascular changes.
The next step for you is to schedule an appointment with a neurologist
. He or she can study you MRI and attempt to interpret its findings in the context of your symptoms and you current neurological exam. If the neurologist feels that these changes are real, then you will need aggressive control of your blood pressure, cholesterol, and any other related condition that is found. You will also need tested for diabetes. If your doctor
does not feel that these changes are real, he or she will still be able to help you with your headaches. Good luck.