Could white matter spots on an mri necessarily be a death sentence?

Not at all.: Small white spots in the white matter on MRI are not uncommon. They are typically seen in middle to older ages from chronic small vessel changes, usually secondary to diabetes and hypertension. Rarely they can be seen with multiple sclerosis and other diseases. They can be from old shearing trauma (such as a bad vehicle accident). They are nonspecific & may require further evaluation to find out.