title: Rapid cognitive decline: not always Creutzfeldt-Jakob disease.
abstract: A patient with rapidly progressive cognitive decline over an approximately four month period was suspected to have sporadic Creutzfeldt-Jakob disease. Features thought to support this diagnosis included psychiatric symptoms (anxiety and depression), visual hallucinations and a visual field defect. However, the finding of papilloedema broadened the differential diagnosis. Although standard brain imaging and electroencephalography had shown only non-specific abnormalities, subsequent cerebral angiography disclosed an intracranial dural arteriovenous fistula. Following embolisation, the patient made a good functional recovery. Intracranial dural arteriovenous fistula merits consideration in any patient with subacute cognitive decline, and should be included in the differential diagnosis of sporadic Creutzfeldt-Jakob disease.
authors.affiliation: AJ Larner, Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK. Email a.larner@thewaltoncentre.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Randall
authors.forename: R
authors.initials: R
authors.lastname: Ellis
authors.forename: B
authors.initials: B
authors.lastname: Hywel
authors.forename: R R
authors.initials: RR
authors.lastname: Davies
authors.forename: S H
authors.initials: SH
authors.lastname: Alusi
authors.forename: A J
authors.initials: AJ
authors.lastname: Larner
mesh_terms: D000368:Aged; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis*; D002533:Cerebral Angiography; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology; D007562:Creutzfeldt-Jakob Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000175:diagnosis*
keywords: Creutzfeldt-Jakob disease; intracranial dural arteriovenous fistula; reversible dementia