Q: What is the preferred and differential diagnosis? show answer
Progressive impairment of recent/short-term memory with relative preservation of remote and autobiographical memory.
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The sulci and ventricles are mildly more prominent than expected for age. The mesiotemporal structures, including the temporal horns of the lateral ventricles and the collateral sulci, are slightly more prominent, with bilateral hippocampi and entorhinal cortices of reduced volume.
Multiple FLAIR hyperintense lesions in the supratentorial white matter, confluent in the periventricular regions, are in keeping with mild to moderate small vessel ischaemia.
No diffusion restriction or suspicious susceptibility.
Findings are typical of the clinically suspected mild Alzheimer disease. As brain biopsy is rarely carried out imaging plays an important role in confirming the clinical impression of dementia. This is increasingly so as some therapies are emerging.
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- The Australian and New Zealand Neuropsychiatry and Behavioural Neurology Conference 2014: MRI in neuropsychiatry and behavioural neurology.
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