New research detects potential hidden cause of dementia (Fully reversible dementia)

Medical Xpress / Cedars-Sinai Medical Center / Alzheimer's & Dementia: Translational Research ^ | Jan. 23, 2023 | Wouter I. Schievink et al

[ConservativeMind]

A study suggests that some patients diagnosed with behavioral-variant frontotemporal dementia (bvFTD)—an incurable condition that robs patients of the ability to control their behavior—may instead have a cerebrospinal fluid leak, which is often treatable.

Cerebrospinal fluid (CSF) circulates in and around the brain and spinal cord to help cushion them from injury. When this fluid leaks into the body, the brain can sag, causing dementia symptoms. Schievink said many patients with brain sagging—which can be detected through MRI—go undiagnosed, and he advises clinicians to take a second look at patients with telltale symptoms.

Clinicians can also ask about a history of severe headaches that improve when the patient lies down, significant sleepiness even after adequate nighttime sleep, and whether the patient has ever been diagnosed with a Chiari brain malformation. Brain sagging, Schievink said, is often mistaken for a Chiari malformation.

Even when brain sagging is detected, the source of a CSF leak can be difficult to locate. When the fluid leaks through a tear or cyst in the surrounding membrane, it is visible on CT myelogram imaging with the aid of contrast medium.

Schievink and his team recently discovered an additional cause of CSF leak: the CSF-venous fistula. To detect these leaks, technicians must use a specialized CT scan and observe the contrast medium in motion as it flows through the cerebrospinal fluid.

Investigators used this imaging technique on 21 patients with brain sagging and symptoms of bvFTD, and they discovered CSF-venous fistulas in nine of those patients. All nine patients had their fistulas surgically closed, and their brain sagging and accompanying symptoms were completely reversed.

The remaining 12 study participants, whose leaks could not be identified, were treated with nontargeted therapies designed to relieve brain sagging. However, only three of these patients experienced relief from their symptoms.

[Diana in Wisconsin]

Dad always said that Tupperware caused cancer. You can look in any kitchen cupboard around the WORLD and you’re bound to find at least one piece of the stuff. ;)

I miss the old days when Parents and Grandparents died of ‘old age.’ :(