Dementia

Question 1

What type of dementia?

medial temporal lobe atrophy (MTA) and parietal atrophy.

Answer 1

Alzheimer’s disease- AD

Question 2

What type of dementia?

(asymmetric) frontal lobe atrophy and atrophy of the temporal pole.

Answer 2

Frontotemporal Lobar degeneration - FTLD

Question 3

What type of dementia?

global atrophy, diffuse white matter lesions, lacunes and ‘strategic infarcts’ (infarcts in regions that are involved in cognitive function).

Answer 3

Vascular dementia

Question 4

What type of dementia?

usually no specific abnormalities.

Answer 4

Dementia with Lewy bodies- DLB

Question 5

The Global Cortical Atrophy is best assessed on this sequence:

Answer 5

FLAIR

Question 6

The Medial Temporal Atrophy is best assessed on this sequence:

Answer 6

Coronal T1

Question 7

Scoring system used i Parietal atrophy

Answer 7

Koedam score for Parietal Atrophy

Question 8

Scaling system for WM lesions

Answer 8

Fazekas scale for WM lesions

Question 9

list the Koedam score for PL atrophy

Answer 9

0- no atrophy
1 - Mild widening of posterior cingulate and Parietooccipital sulci
2- substantial
3 - extreme

Question 10

FDG PET findings for AD

Answer 10

Hypo metabolism in TP lobe and or posterior cingulum

Question 11

Ddx AD from FTD on PET

Answer 11

AD : affects TP lobe

FTD: FL

Question 12

MTA is assessed on these features (3)

Answer 12

1. Width of choroid fissure
2. Width of temporal horn
3. Height of Hippocampal formation

Question 13

Name the drug that is used for treatment of vascular dementia/ LB dementia

Answer 13

cholinesterase inhibitors

Question 14

T/F?

FLAIR is a good sequence to look at infratentorial region and for spinal cord

Answer 14

FALSE

LIMITED use of FLAIR in these areas- It suppresses signal from water as well as pathology with long T1 relaxation time.

Question 15

The FTLD is formerly known as…

Answer 15

Pick’s disease

Question 16

How would patients with FTLD present with?

Answer 16

behavioural and language disturbances

Question 17

What is an asymmetrical FTLD?

Answer 17

In Semantic dementia, an FTLD subtype with progressive aphasia and Left sided TL degeneration

Question 18

What conditions associated with Lewy body dementia (3)

Answer 18

1. Atypical parkinson syndrome
2. Progressive Supranuclear Palsy- PSP
3. Multi System Atrophy- MSA

Question 19

How would patients with LB dementia present?

Answer 19

1. Detailed visual hallucination
2. Parkinson like symptoms
3. Fluctuations in alertness and attention

Question 20

PSP

Answer 20

Part of atypical parkinsonian syndrome, with atrophy of midbrain
Upward gaze paralysis

Hummingbird sign

Question 21

MSA

Answer 21

Combination of :

• Parkinsonian : MSA - P
• Cerebellar : MSA - C
• Pyramid
• Autonomic dysfunction : MSA - A ( formerly known as Shy- Drager syndrome)

Question 22

MSA - A is formerly known as…

Answer 22

Shy Drager syndrome

Question 23

Sign associated with MSA- C

Answer 23

Hot Cross Bun sign-

Question 24

Re CJD

• What is it caused by?
• How do they present?

Answer 24

Caused by Prion

Present with progressive dementia leading to :

• memory loss
• personality changes
• hallucination

Question 25

Imaging CJD

Answer 25

Spongiform changes in the cortical and subcortical grey matter with loss of neurons and replacement by gliosis.

Question 26

What sequence is used to detect CJD

Answer 26

DWI

Question 27

Where is affected in mad cow disease?

Answer 27

posterior part of thalamus known as pulvinar

Question 28

Corticobasal degeneration- CBD

Answer 28

cognitive dysfunction with parkinson like symptoms .

Question 29

Typical manifestation of CBD

Answer 29

Alien hand syndrome

Question 30

MRI findings in CBD

Answer 30

asymmetrical parietal cortical atrophy with associated hyper intensities of the WM on T2

Question 31

Patients with huntingdon disease present with:

Answer 31

Early onset dementia Choreoathetosis Psychosis

Question 32

Imaging features of Huntingdon disease

Answer 32

Atrophy of caudate nucleus and subsequent enlargement of the frontal horns of the LV

Question 33

CADASIL

Answer 33

hereditary condition- progressive cognitive dysfunction; may present with migraine, stroke like episodes and behavioural disturbances.

Question 34

Imaging features of CADASIL

Answer 34

WM hyper intensities in FL and anterior TL with lacunar infarcts