A 76-year-old man presented to the outpatient neurology service with fatigue and confusion of several months duration. His wife had recently noticed that he also had some memory impairment. The patient was a dental technician and was still active at work. He had mild hypertension. The only medication he was taking was aspirin (100 mg per day). At presentation, his systolic blood pressure was 160 mm Hg, and his diastolic blood pressure was 80 mm Hg. Funduscopic examination revealed mild arterial narrowing and sclerosis. The patient was alert and perfectly oriented. His Mini-Mental State Examination score was 27 (25.3 after correction for age and education), with some failure on memory tasks. The rest of the neurologic examination was normal. The results of routine blood tests performed at presentation were normal. The erythrocyte sedimentation rate; levels of C-reactive protein and extractable nuclear antigen, lupus anticoagulant, and anticardiolipin antibodies; and prothrombin and partial thromboplastin times were normal. Serum protein electrophoresis findings were negative. This patient was considered to have mild cognitive impairment (amnestic type) and was referred for brain computed tomography (CT), which was followed the next day by 0.5-and 1.5-T magnetic resonance (MR) imaging.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging