Presentation
Recurring falls and concern for early dementia.
Patient Data
There is relatively symmetric cortical reduced diffusivity along both medial frontal and parietal lobes and insular cortices left greater than right. There is also reduced diffusivity within the caudate nuclei, putamen, and medial thalami.
The ventricles and sulci are mildly prominent reflecting a mild degree of parenchymal volume loss. There are mild scattered foci of T2/FLAIR hyperintensity within the periventricular and subcortical white matter. There appears to be previous cataract surgery.
Case Discussion
This is a case of Creutzfeldt-Jakob disease showing symmetrically restricted diffusion of the bilateral frontoparietal lobes, as well as within the caudate nuclei, putamen, and medial thalami.
Following this MRI, a lumbar puncture was performed and cerebrospinal fluid was collected for analysis. The patient was found to have elevated T tau protein (>3000; reference range 0-1149) and positive for 14-3-3 protein.
CO-AUTHORS:
Daniel Gewolb, MD
Joseph Giampa, MD
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