Vascular Dementia

The patient was a 76 year old woman who had a history of porcine valve replacement for aortic stenosis and stroke with left hemiparesis, who became withdrawn and suspicious of her surroundings. She had an abrupt decline in memory function and processing speed at the time of the stroke, but had shown some improvement and was living independently. Images show evidence of an old "slit hemorrhage" in the right basel ganglia (lateral putamen, here), as well as several other small deep white and grey matter lesions which probably represent infarction. The perfusion pattern is consistent with vascular disease as well, since multiple perfusion defects can be seen throughout the brain.
Some details have been altered to protect confidentiality.
Keith A. Johnson (, J. Alex Becker (