Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 54 year old man with progressive apathy and cognitive.

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Presentation transcript:

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 54 year old man with progressive apathy and cognitive impairment

VIGNETTE A 54-year-old man developed apathy, inattention and memory impairment in 3 months. Wechsler Memory Scale-Revised (WMS-R) scores were mostly SD below his age group, especially worse in delayed recall index scored 55. MRI showed bilateral thalamic hyperintensiteis in T2- and diffusion- weighted images with dilated cortical veins in the right cerebellum. Iwasawa et al.

IMAGING Iwasawa et al. Figure 1 Figure 2

Reversible Cognitive Impairment with Bithalamic Lesions Caused by a Dural Arteriovenous Fistula His bithalamic venous congestion was caused by unilateral transverse-sigmoid dAVF due to non-communication between the right-and- left transverse sinuses, occurring 18% of normal population. Dural AVF is a rare cause of bithalamic lesions and cognitive impairment. Iwasawa et al.