FINDINGS Figure 83-1. Top row: Axial FLAIR MRI. There is mild bilateral temporoparietal volume loss. Second, third, and fourth rows: Axial and surface projection maps F-18 FDG PET. There is bilateral posterior temporal and parietal hypometabolism (right greater than left). Posterior temporal and parietal hypometabolism with preservation of precentral gyrus metabolism is a characteristic feature of Alzheimer disease (AD).
DIFFERENTIAL DIAGNOSIS Vascular dementia, frontotemporal dementia, Lewy body dementia, corticobasal degeneration, normal pressure hydrocephalus.
DIAGNOSIS AD.
DISCUSSION AD is a progressive neurodegenerative disorder that manifests with gradual deterioration in cognition, behavior, and motor function. It is the most common dementia in the elderly followed by vascular and frontotemporal dementias. The definitive diagnosis is obtained through brain biopsy showing accumulation of extracellular senile β-amyloid plaques and intracellular neurofibrillary tangles formed by tau proteins.
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