Clinical History: A 70 years old male presented with history of progressive forgetfulness since past few months. H/o involuntary movements of the head and upper extremities was noted. No h/o weakness. No h/o past vascular insult/stroke. On examination no focal neurological deficit seen.
Imaging Findings: Patient referred for Plain MR imaging with clinical diagnosis of Parkinsonism / Lewy-body disease/ Alzheimer’s disease.
Plain MRI findings revealed:
- Severe grey matter atrophy involving both the cerebral hemispheres, with predominant volume loss in both temporal lobes. Atrophy of hippocampal formations also noted.
- The subarachnoid spaces were prominent with dilated ventricular system particularly the temporal horns. The sylvian fissures appeared markedly widened.
- The brainstem appears normal. Pars compacta shows normal thickness on both sides.
- No focal white matter abnormality detected.
- Multivoxel Spectroscopy revealed increase in the Myo-inositol metabolite levels and reduced NAA levels.
Final Diagnosis: Alzheimer’s Disease.