Computerized Transverse Axial Scanning in the Diagnosis of Presenile Dementia

Abstract

The author has been studying degenerative changes of the brain in the case of presenile dementia in the aid of computerized transverse axial scanning (computer tomography)since 1976. In the present paper the author has reported clinical features and evolutions of seven patients with presenile dementia, of whom two were diagnosed as Pick's disease and five as Alzheimer's disease exclusively from the clinical viewpoint, with reference to Polaroid pictures of computer tomographic print-outs. At the same, their results have been compared with those who are regarded as normal and with one who are diagnosed as senile dementia.
In th e case of Pick's disease, a marked enlargement of ventricular system were commonly found in the two cases particularly in the anterior portions, while in the case of Alzheimer's disease, such an enlargement were not seen in three cases but only in two cases. Two cases of Alzheimer's disease showed a generalized enlargement of the ventricular system and little enlargement of the cerebral sulci, while the three cases presented no marked enlargement of the ventricular system but of cerebral sulci and fissures. The patient with senile dementia showed moderate enlargements of cerebral sulci, fissures and ventricular system, which were seen in one of the latter three patients with Alzheimer's disease. It is of particular interest that the two patients with Alzheimer's disease have been differentiable from the other three based on the difference of clinical features whether or not there were specific local syndromes of the brain such as aphasia, agnosia and apraxia. Actually, computer tomography is quite useful in the clinical diagnosis of presenile dementia.