PROF.DR.K.H.NOORUL AMEEN’S UNIT

M.ARIVUMANI

c/o difficulty in walking for the past 1 month memory disturbances urinary incontinence Known hpertensive on irregular treatment

O/E Pt concious,oriented PR-74/min BP 160/100mmhg CVS/RS/ABDOMEN- NAD

CNS-memory disturbances + bradykinesia + rigidity + able to walk ,no arm swing b/l plantar flexor MMSE score 22

Multiple focal areas of hyperintensities in subcortical white matter and periventricular regions in T2 w and FLAIR

Suggestive of Small vessel disease

Unidentified bright objects (UBO) or deep white matter ischemia or Leukoencephalopathy

Subcortical arteriosclerotiic encephalopathy Affects poorly collateralised penetrating arteries HT,DM,Smoking,heart disease are risk factors Chronic HT leads to lipohyalinosis of small

vessel disease. Bilateral patchy or diffuse areas of

hyperintensity of cerebral white matter. Best seen in T2 weighted MRI or in FLAIR

images.

SMALL VESSEL DISEASE MULTIPLE LACUNAR INFARCT MIGRAINE VASCULITIS SARCOIDOSIS LEUKODYSTROPHY APLA PML POST RT

OLD AGEMULTI INFARCT DEMENTIAALZHEIMER DISEASEBINSWANGER DISEASEMETACHROMATIC LEUKODYSTROPHYPROGRESSIVE MULTIFOCAL

LEUKOENCEPHALOPATHYCADASILCEREBRAL AMYLOID ANGOPATHY

Harrison ‘s principles of internal medicine

Adams radiology Wolfgang radiology review.

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