Presentation
Progressive dementia and ataxia.
Patient Data
Both cerebral hemispheres demonstrate diffusion restriction on ADC images (unfortunately b=1000 images are not available) with some high T2 signal also visible within the cortex of FLAIR images. Diffusion restriction also in the bilateral corpus striatum.
Volume loss of bilateral cerebral hemispheres is evident by widening of adjacent cerebral sulci.
Case Discussion
The features of diffuse cortical injury can be seen in a variety of disease processes which can be remembered using the mnemonic CRUMPLED: Creutzfeldt-Jakob disease, Reversible cerebral vasoconstriction syndrome; Urea cycle disorders; Mitochondrial; Prolonged seizures and posterior reversible encephalopathy syndrome; Laminar necrosis and Liver-related; Encephalitis; Diabetes mellitus (hypoglycemia).
In the current case, taking into consideration the patient's age and clinical presentation, the possibility of Creutzfeldt-Jakob disease looks more likely, as the corpus striatum is involved as well.