This 63-year-old male presents with headache, memory loss, ataxia. Patient has history of cerebral atrophy and ventriculomegaly on CT five years prior. Clinical concern for normal pressure hydrocephalus and / or multiple chronic strokes. Patient states motor vehicle accident three years prior and, since then, brain atrophy with memory loss increasing in severity. No history of prior surgery or cancer.
There is marked left hippocampal atrophy as well as slight asymmetric atrophy of the temporal lobes, and to a lesser degree the parietal lobes. Additionally, diffuse thinning of the midbrain with decreased ratio of midbrain to pons area. Differential considerations should include:
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