Dementia syndromes Flashcards
1
Q
Reversible causes of dementia
A
- intracranial and systemic causes
- normal pressure hydrocephalus
- subdural haematoma
- cerebral tumours
- tertiary syphilis
- alcohol
- anoxia
- hypoglycaemia
- myxoedema
- vitamin deficiencies
- drug or chemical poisoning
- pseudodementia
- renal and hepatic disease
2
Q
Alcohol related dementia
A
- accounts for 12% of young onset dementia
- prolonged heavy use can cause damage to limbic structures and frontal lobes
- memory impairment can improve following a prolonged abstinence
- autobiographical memory is affected
- confabulation can occur
- neuroimaging may be non-specific or may show generalised cortical atrophy with frontal preponderance
3
Q
Normal pressure hydrocephalus
A
- dliation of the cerebral ventricles (especially 3rd)
- normal CSF pressure on LP
- -dementia, gait ataxia and incontinence
- 0.4% of elderly
- dementia is subcortical and potentially reversible
- 50% are idiopathic
- 50% are secondary to mechanical obstruction of CSF flow across the meninges due to infection, trauma, SAH
- urinary incontinence is a late symptom
- CT shows enlarged lateral ventricles
- needs a ventriculo-peritoneal shunt
- gait improves with shunting
4
Q
Chronic subdural haematoma
A
- subdural veins are more vulnerable to tears in older people due to cortical shrinking
- -30% have bilateral SDH
- history of head injury occurs in only 50% patients
- may not be recent trauma
- headache, drowsiness, altered consciousness, confusion
- CT scan shows crescent shaped haematoma compressing sulci and midline shift (may not be seen in first 3 weeks)
- surgical burr holes or steroids
- mortality is 10%
