Presentation
Cognitive impairment.
Patient Data
Moderate chronic small vessel ischemic changes scattered throughout both hemispheres. The hippocampi are bilaterally, symmetrically, disproportionately volume depleted. The remainder of the brain demonstrates only minor generalized volume loss. Multiple peripherally located micro hemorrhages are seen throughout both hemispheres suggestive cerebral amyloid angiopathy. Features support a diagnosis of Alzheimer's disease
Case Discussion
In this age group, the presence of bilateral disproportionate volume depletion of the hippocampi along with the presence of microhemorrhages peripherally and a matching clinical history (short term memory loss) makes the diagnosis of Alzheimer's disease almost certain, especially as the baseline prevalence in this group is very high.