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Lewy body dementia

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Relatively rapid progressive decline in function and cognition. No particular language or striking memory deficit.

Patient Data

Age: 70 years
Gender: Male
mri

There are no intra- or extra-axial mass lesions, acute hemorrhages or collections. No acute infarcts. There a few scattered punctate foci of bi-hemispheric FLAIR high-signal, in keeping with mild chronic white matter ischemic change. No regions of abnormal supra- or infra-tentorial susceptibility blooming.

There is generalized cerebral involution demonstrated, exaggerated for age with no definite focal predilection.

Case Discussion

The neuroimaging findings of Lewy body dementia are subtle and non-specific and in fact the role of neuroimaging in this setting is to exclude other causes of dementia, especially posterior cortical atrophy (Alzheimer's disease variant) and vascular dementia. 

The clinical presentation is therefore paramount and care must be taken in taking this into account when reporting these studies. 

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