Dementia Flashcards
What type of dementia?
medial temporal lobe atrophy (MTA) and parietal atrophy.
Alzheimer’s disease- AD
What type of dementia?
(asymmetric) frontal lobe atrophy and atrophy of the temporal pole.
Frontotemporal Lobar degeneration - FTLD
What type of dementia?
global atrophy, diffuse white matter lesions, lacunes and ‘strategic infarcts’ (infarcts in regions that are involved in cognitive function).
Vascular dementia
What type of dementia?
usually no specific abnormalities.
Dementia with Lewy bodies- DLB
The Global Cortical Atrophy is best assessed on this sequence:
FLAIR
The Medial Temporal Atrophy is best assessed on this sequence:
Coronal T1
Scoring system used i Parietal atrophy
Koedam score for Parietal Atrophy
Scaling system for WM lesions
Fazekas scale for WM lesions
list the Koedam score for PL atrophy
0- no atrophy
1 - Mild widening of posterior cingulate and Parietooccipital sulci
2- substantial
3 - extreme
FDG PET findings for AD
Hypo metabolism in TP lobe and or posterior cingulum
Ddx AD from FTD on PET
AD : affects TP lobe
FTD: FL
MTA is assessed on these features (3)
- Width of choroid fissure
- Width of temporal horn
- Height of Hippocampal formation
Name the drug that is used for treatment of vascular dementia/ LB dementia
cholinesterase inhibitors
T/F?
FLAIR is a good sequence to look at infratentorial region and for spinal cord
FALSE
LIMITED use of FLAIR in these areas- It suppresses signal from water as well as pathology with long T1 relaxation time.
The FTLD is formerly known as…
Pick’s disease
How would patients with FTLD present with?
behavioural and language disturbances
What is an asymmetrical FTLD?
In Semantic dementia, an FTLD subtype with progressive aphasia and Left sided TL degeneration
What conditions associated with Lewy body dementia (3)
- Atypical parkinson syndrome
- Progressive Supranuclear Palsy- PSP
- Multi System Atrophy- MSA
How would patients with LB dementia present?
- Detailed visual hallucination
- Parkinson like symptoms
- Fluctuations in alertness and attention
PSP
Part of atypical parkinsonian syndrome, with atrophy of midbrain
Upward gaze paralysis
Hummingbird sign
MSA
Combination of :
- Parkinsonian : MSA - P
- Cerebellar : MSA - C
- Pyramid
- Autonomic dysfunction : MSA - A ( formerly known as Shy- Drager syndrome)
MSA - A is formerly known as…
Shy Drager syndrome
Sign associated with MSA- C
Hot Cross Bun sign-
Re CJD
- What is it caused by?
- How do they present?
Caused by Prion
Present with progressive dementia leading to :
- memory loss
- personality changes
- hallucination
Imaging CJD
Spongiform changes in the cortical and subcortical grey matter with loss of neurons and replacement by gliosis.
What sequence is used to detect CJD
DWI
Where is affected in mad cow disease?
posterior part of thalamus known as pulvinar
Corticobasal degeneration- CBD
cognitive dysfunction with parkinson like symptoms .
Typical manifestation of CBD
Alien hand syndrome
MRI findings in CBD
asymmetrical parietal cortical atrophy with associated hyper intensities of the WM on T2
Patients with huntingdon disease present with:
Early onset dementia
Choreoathetosis
Psychosis
Imaging features of Huntingdon disease
Atrophy of caudate nucleus and subsequent enlargement of the frontal horns of the LV
CADASIL
hereditary condition- progressive cognitive dysfunction; may present with migraine, stroke like episodes and behavioural disturbances.
Imaging features of CADASIL
WM hyper intensities in FL and anterior TL with lacunar infarcts
