
My Mum Was 90 Years Old When She Had A

Generalised involutional changes with right parietal subcortical ischaemic changes otherwise normal brain parenchyma, ventricles, sulci and the CSF spaces for the age of the patient without any prominent brain volume loss, ischaemic changes, mass lesion or extra axial collection. No orbital, sinus or bony pathology. Idiopathic basal ganglia calcification. Normal sella, parasellar region. No vascular pathology. Skull base appear unremarkable. Moderate bony osteopenia.
She has mild shrinkage of brain.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted the CT scan report of your mother. It shows mild cerebral atrophy (shrinkage of brain), which could be normal for a 90-year old. In addition, she also has ischemic changes (decreased blood supply) to a part of brain on the right side.
Based on this, we can not conclude that she has dementia/Alzheimer's disease.
Detailed neuropsychological assessment and MRI brain would further help in the diagnosis.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


I understand that you cannot say if she has Alzheimers/dementia, however,
would the shrinkage of the brain and the decreased blood supply cause any damage to the brain and/or mental impairment?
Yes, it can cause impairment of brain functions.
Detailed Answer:
Thank you for getting back.
Shrinkage of brain and decreased blood supply to brain, both can cause impairment of brain functions. If they are severe enough to impair her activities of daily living, it would classify as dementia.
Dr Sudhir Kumar MD DM


For around 5 years or more my mum has been confused and it became prudent to set up Power of Attorney. Mum would leave pans burning, the grill burning and the smoke alarm screeching until we stopped her cooking. Mum couldn't cope with paying bills (often crying on the phone) or finances in general. She'd often stay in bed until at least noon and often well into the afternoon. I'd find her sat in her armchair (even in the middle of a cold winter) with the lounge curtains closed, the television off, no heating on, no lights on, sat like a zombie in complete darkness. Mum would take hours sometimes to finish a simple meal, and often ignored cutlery by eating with her hands.
Mum has incurred most of the symptoms quite suddenly in November 2018, even going to a next door neighbour in a distressed state with a confused scrawl of a Will and Testament that she wanted them so sign. This happened again not long after with another neighbour. Mum thinks she has hairs growing out of her mouth and cheeks, and into her mouth too. She thinks her skin is peeling off, sometimes in sheets, and claims her ears are blocked by wax.
None of these symptoms are valid and she'll claim her wax is invisible when a doctor finds nothing.
15mg of Mirtazapine daily had no effect. 2.5mg of Olanzapine had no effect. Upping the Olanzapine to 5mg daily helped a little with her appetite and her weight loss, but she's continued truly believing she's dying almost every day since November 2018, and she'll pick at her face for hours at a time, and make her nose bleed. I've had phone call after phone call with her in terror of dying on her own.
My mum's panic attacks have even lead to a cataract operation under local anaesthetic being cancelled on the day of the operation, and having to reschedule it for general anaesthetic.
In addition, a care agency morning carer had to call out paramedics and it was only when my distressed mum went on about melting skin that I was contacted and prevented mum being taken to hospital.
Mum will also put dirty clothing into the tumble dryer, and also leave wet clothes in the washing machine which she can't say have just got wet, or been actually washed yet forgotten, maybe for days.
She won't read anything except the TV guide and also can't cope with crosswords and codeword puzzles even though she used to love doing them in the past.
What would you deduce from these symptoms? XXXXXXX Farmer
Symptoms are suggestive of dementia.
Detailed Answer:
Thank you for getting back with more elaborate clinical details.
These are highly suggestive of dementia. Psychiatric symptoms suggest that she could have depression and psychosis too. Patients with dementia are known to have mood and behavioural disturbances, so, there is no need to think of an additional diagnosis.
So, now that dementia is very likely, further evaluation should focus on finding its cause- whether it is Alzheimer's disease or something else.
In this regard, neuro-psychological assessment, PET-CT scan of brain, etc would help. It is another matter, how much investigations, do you want to pursue.
Dr Sudhir Kumar MD DM (Neurology)


With gratitude
Regards XXXXXXX Farmer
Thank you.
Detailed Answer:
It would be my pleasure to be of any help in future too.
Wishing your mother the best of health,
Dr Sudhir Kumar MD DM

Answered by

Get personalised answers from verified doctor in minutes across 80+ specialties
