title: Unusually rapid and severe cognitive deterioration after mild traumatic brain injury.
abstract: A 56-year-old man (AB) presented with dramatic cognitive deterioration following a mild traumatic brain injury. There was no indication of severe brain injury or significant anoxic encephalopathy. Detailed history indicated no significant pre-morbid cognitive deficits. His pre-injury psychosocial and occupational functioning was intact. Cognition functioning was impaired immediately post-injury and remained impaired. Neuropsychological examination at 8 months post-injury showed severe cognitive deficits. The cognitive profile was consistent with Alzheimer's disease. MRI at 1-year post-injury showed minor ischaemic changes not consistent with hypoxic injury and insufficient to explain his cognitive problems. Early SPECT was consistent with a diagnosis of Alzheimer's disease and a repeat SPECT showed a significant deterioration in an Alzheimer pattern. AB was seen for detailed serial neuropsychological examination over a 3-year period, which revealed clear evidence of cognitive deterioration consistent with Alzheimer's disease. AB is presented as an unusual case of rapid progressive AD following a mild head injury.
authors.affiliation: St James's University Hospital, Leeds, UK. steven.kemp@leedsth.nhs.uk
authors.forename: Steven
authors.initials: S
authors.lastname: Kemp
authors.forename: Peter
authors.initials: P
authors.lastname: Goulding
authors.forename: John
authors.initials: J
authors.lastname: Spencer
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D001930:Brain Injuries / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests