Previous Case

Next Case

Neuroradiology Case of the Month

July 2001

Clinical Presentation: A 66-year-old woman was found unresponsive on the floor in the nursing home.

Radiographic findings: CT (Fig. 1) shows marked dilatation of the frontal horns of the lateral ventricle, and temporal horns. The cortical sulci were also prominent in the frontal lobes and temporal lobes. CT attenuation values in the periventricular deep white matter were decreased.

Diagnosis: Pick's disease. Biopsy proven.

Figure 1. CT shows marked dilatation of the anterior and temporal horns of the lateral ventricle. Frontal deep white matter shows low density bilaterally.

Discussion: Pick's disease is a rare cause of dementia. It is characterized by frontotemporal degeneration with Pick bodies and ballooned neurons [1]. Atrophy typically affects the frontal and temporal lobes. CT and MRI may suggest the diagnosis [2]. However, based on imaging findings only, it is difficult to differentiate Pick's disease from other frontotemporal dementia with neither Pick bodies nor ballooned neurons.

References:

1. Dickson DW. Neuropathology of Pick's disease. Neurology 2001;56:S16-S20
2. McGeachie RE et al. Case report. Diagnosis of Pick's disease by computed tomography. J Comput Assist Tomogr 1979;3:113-115