Progressive neuropsychiatric symptoms and motor impairment.
A 42-year-old white man presented with cognitive impairment and behavioral changes followed by rapidly progressive motor and gait impairment. Magnetic resonance imaging revealed striking multifocal white matter signal change, areas of restricted diffusion, diffuse callosal signal change, and atrophy and hyperintensity of the corticospinal tracts. A broad range of etiologies warrant consideration in this case, including degenerative, vascular, inflammatory, metabolic, and neoplastic diseases.
Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia.
Mahtab
M
Ghadiri
Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia2Discipline of Neuropathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Michael E
ME
Buckland
Department of Neurology, St Vincent's Hospital, Sydney, New South Wales, Australia.
Ian J
IJ
Sutton
Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia2Discipline of Neuropathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Suad
S
Al Jahdhami
Discipline of Neuropathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia4Department of Pathology, University of Sydney, Sydney, New South Wales, Australia.
Simon
S
Flanagan
Westmead Millennium Institute, University of Sydney, Sydney, New South Wales, Australia.
Robert
R
Heard
Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia.
Yael
Y
Barnett
Department of Neurosurgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Jeffrey
J
Brennan
Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia7Institute of Clinical Neurosciences, Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Michael H
MH
Barnett
D000328:Adult; D001284:Atrophy / Q000150:complications; D001369:Axons / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D056324:Diffusion Tensor Imaging / Q000379:methods; D018450:Disease Progression; D006801:Humans; D008297:Male