Presentation
Short term memory impairment, rapid cognitive deterioration, cerebellar signs with progressive gait disturbance, peripheral lower extremity sensory impairment and numbness.
Patient Data
Bilateral, symmetric diffusion restriction and high T2/FLAIR signal in the putamen, caudate nucleus, and thalamus involving the dorsomedial and pulvinar thalamic nuclei. No abnormal cortical signal or diffusion restriction.
Case Discussion
The clinical syndrome, especially with the rapid cognitive deterioration, the typical MRI pattern and the lack of possible alternative diagnoses led to the diagnosis of Creutzfeldt-Jakob disease. The symmetric diffusion restriction in the pulvinar and dorsomedial thalamic nuclei has a shape of a hockey stick which is called the hockey stick sign.
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