Concluded Case

Cerebral Small vessel disease with Vascular Dementia

88yr old ,M, Presntedcwith progressive memory impairement for the last 2yrs ,aggravated for 6 months. For the last 6months he has nocturnal urinary incontinence with visual hallucination.Sleep also disturbed, and tendency to walk around at night . Not a known Diabetic of hypertensive. Not on any specific medicine. On exam BP 130/90 mmhg . MMSE 17/ 30. No definiteong teactsigns. Blood biochemistry including S B12 ,TSH,Vit D etc - Normal. PSA WITHIN MORMAL.. MRI Brain done. What abnormality in the MRI brain and what is the diagnosis?.

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Concluded answer

Tganks for the answer. MRI brain shows * Bilateral subdural hygroma. * Chronic small vessel ischemic changes of white matter( Fazeka gr 11), pons and bilateral thalamus. * Chronic lacunar infarction Rt thalamus. * Age related cortical atrophy. For documentation ,neurosurgeon was also seen the case. Started an antiplatelet,statin ,Donepezil with memantine. Well informed the family regarding the MRI abnormalities and home care of dementia Diagnosis CSVD with vascular dementia

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Tganks for the answer. MRI brain shows * Bilateral subdural hygroma. * Chronic small vessel ischemic changes of white matter( Fazeka gr 11), pons and bilateral thalamus. * Chronic lacunar infarction Rt thalamus. * Age related cortical atrophy. For documentation ,neurosurgeon was also seen the case. Started an antiplatelet,statin ,Donepezil with memantine. Well informed the family regarding the MRI abnormalities and home care of dementia Diagnosis CSVD with vascular dementia

Madam to me it's a progressive Dementia disease perhaps may be AD. But it's associated with progressive symptoms due to chronic SDH. Clinically which lobes involved from lobar function?

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