Had a repeat MRI of the head. She had a lesion seen in the right frontal lobe on previous CT and MRI scanning. This lesion has not changed at all over time. I have reviewed this with our neuroradiologist here, and it seems somewhat unlikely that this is a low-grade glioma. We have really pursued quite a great deal in the way of workup for this very unfortunate woman’s dementia. One thing that we had not done was a lumbar puncture, and I think that this is probably quite reasonable given the fact that we have not found a treatable cause for her memory loss and are really, more or less, presuming that the underlying disease is Alzheimer disease.
I would suggest that a lumbar puncture be done and that spinal fluid be sent for VDRL, AFB stain and culture, fungal stain and culture, cryptococcal antigen, bacterial culture, glucose, protein, and cell count.
No comments:
Post a Comment