Alzheimer disease - probable

Case contributed by Dr Bruno Di Muzio

Presentation

Progressive cognitive impairment.

Patient Data

Age: 60 years
Gender: Male
Nuclear medicine

SPECT

RADIOPHARMACEUTICAL: 99mTc HMPAO, 781 MBq

SPECT studies of the brain were performed.

Mild to moderate severity hypoperfusion is seen in the parietal (left > right), posterior left temporal cortex and posterior cingulate, with preservation of the sensorimotor cortex.

Brainstem, basal ganglia and cerebellar perfusion are normal.

MRI

Mild left parietal atrophy without overt mesial temporal lobe atrophy. No other lobar atrophy.

Bilateral cerebellar tonsillar herniation below the foramen Magnum, measuring up to 11 mm, with associated mild crowding at foramen Magnum. No hydrocephalus and no compression of the cervicomedullary region.

No significant small vessel ischemic change and no evidence of previous cortical infarction nor intracranial hemorrhage.

No overt regional hypoperfusion in ASL sequence.

Conclusion: Mild left parietal atrophy, correlating with relative hypoperfusion in this region on SPECT. No significant vascular disease. Incidental Chiari 1 malformation.

Case Discussion

Alzheimer disease is a common neurodegenerative disease, responsible for the majority of all dementias, and imposing a significant burden on developed nations.

This case was diagnosed as being a probable Alzheimer's disease due the clinical scores and history added the SPECT and MRI findings of parietal atrophy. 

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Case information

rID: 35334
Published: 14th May 2015
Last edited: 14th Aug 2019
Tag: rmh
Inclusion in quiz mode: Included

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