Alzheimeir's disease - probable

Case contributed by Dr Bruno Di Muzio


Cognitive impairment.

Patient Data

Age: 62
Gender: Female

MRI Brain

There are multiple focal and confluent predominantly peripheral and to lesser extent periventricular cerebral white matter T2/flair hyperintense lesions. Few of the lesions are in pericallosal locations. There is no significant interval change in the appearance of the brain lesions. There is no involvement of the corpus callosum proper, the brain stem, the cerebellar hemispheres or the imaged upper cervical spinal cord. There is a small cortical-based infarct in the superior aspect of the cerebellar vermis. The overall appearances are of moderate small vessel ischaemic changes rather than demyelination.

There is no restricted diffusion or contrast enhancement. There is mild global parenchymal volume loss with biparietal predominance; such a pattern can be seen in patients with Alzheimer disease.

There is no intra or extraaxial collection or mass lesion

Case Discussion

The MRI images show some nonspecific features such as small vessel ischaemic changes and mild global parenchymal volume loss with biparietal predominance, not expected for this patient age, and that corroborate to the neuropsychiatric clinical hypothesis of Alzheimer's disease

The deep white matter component score (Fazekas) is useful in the assessment of patients with possible dementia (see neurodegenerative MRI brain (an approach)). 

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Case information

rID: 37261
Published: 14th Jun 2015
Last edited: 10th Sep 2015
Tag: rmh
Inclusion in quiz mode: Included

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