57 yr female. increasing fatigue - mental and physical. balance issues, blurry vision when tired and headaches. recent brain mri reported 'fairly extensive cerebral hyperintensities'. poss chronic microvascular ischemia or demyel process. serious?

The MRI is nonspecific and nondiagnostic and the correlations could include many other entities. But am concerned regarding fatigue, potential cognitive issues, associated with imbalance, and visual changes. See a neurologist, and get full evaluation. A lumbar puncture for spinal fluid analysis may provide answers, but blood studies would also be helpful