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‘Bang and it was gone!’: an acute onset dementia?

Renuka Visvanathan, Deepal Lecamwasam, Barry Chatterton

CaseRepClinPractRev 2002; 3(2):71-73

ID: 474528

Background: Dementia is an important diagnosis with clinical, social and legal implications. Common causes of dementia encountered in clinical practice include Alzheimer’s disease, Vascular dementia, Lewy body dementia
and frontotemporal dementia. The gold standard for diagnosis is brain histopathology. Patients with aphasia are significantly disadvantaged as most of the available clinical tools rely heavily on verbal communication. Clinicians
would have to rely heavily on laboratory investigations and imaging to make an accurate diagnosis.
Case Report: A 65-year-old woman presented with an acute episode of severe aphasia. She had been misdiagnosed as suffering from dementia. The history was atypical for that of a dementing illness. Routine dementia
screens revealed no reversible cause and also did not shed light on the actual diagnosis. Delirium and depression were excluded. In this case a 18FDG PET (Positron Emission Tomography) scan confirmed the diagnosis of a cerebrovascular infarction. She was discharged on aspirin.
Conclusion: Accurate diagnosis and classification of dementia is essential for medical management and delivery of suitable services. Unfortunately, the accurate diagnosis of dementia is difficult in someone with aphasia.

Keywords: vascular dementia, cerbrovascular accident, Aphasia, PET

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