Alzheimer disease

Case contributed by Assoc Prof Frank Gaillard

Presentation

Progressive impairment of recent/short-term memory with relative preservation of remote and autobiographical memory.

Patient Data

Age: 70 years
Gender: Female
MRI

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 hippocampus, amygdala and entorhinal cortex reduced in volume.

Multiple FLAIR hyperintense lesions in the supratentorial white matter, confluent in the periventricular regions, are in keeping with mild to moderate small vessel ischemia.

No diffusion restriction or suspicious susceptibility.

Case Discussion

Findings are typical of the clinically suspected mild Alzheimer disease or limbic-predominant age-related TDP-43 encephalopathy (LATE)

Unfortunately, these two entities can not only mimic each other clinically and radiologically but can also co-exist. An amyloid PET can be useful but currently, a definite antemortem diagnosis cannot be reached. 

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Case information

rID: 22196
Published: 19th Mar 2013
Last edited: 15th Apr 2020
Inclusion in quiz mode: Included

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