Do you recommend life long aspirin 81 mg daily for non-specific T2 white matter hyper-intensities on MRI brain?

"Non-specific" means non-specific, indeed, and ASA risks of bleeding increase with age.

I would not prescribe aspirin. I would look at vascular risk factors and treat as indicated. This is also common in migraine.

I agree with @Dr. First Last and most others. There is no treatment necessary unless there is other evidence of small vessel disease. I see 20-year-old patients with migraine and no other issues who have what I call unidentified bright objects or UBOs. I think they increase with age and would not be...

I don’t think there is a yes or no answer to the question posted. Using aspirins or not, in my opinion, depends on how many of the white matter hyper-densities, the patient’s age, stroke risk factors, and family history. Forget about study findings, I don’t think there is any well-designed study on ...

I do not, but if the diagnosis is small vessel disease, cilostazol is an option.

Definitely not if I don't think it's a chronic silent stroke burden and an alternative etiology is more likely.

We called these UBOs (unidentified bright objects) when MRI brain imaging came about in 1988. There are other possible etiologies, such as migraine, a congenital truncated arteriole etc. and are considered incidental when only found on one slice.