Neuroimagem - Pick


          SPECT and MRI study in a 63-year-old woman with probable Pick disease. She demonstrated progressive difficulty initiating speech as well as other activities over the past 6 years that more recently included episodic memory difficulty and bizarre behaviors. A sagittal view of her left hemisphere on MRI (leftmost image) demonstrates relative atrophy in frontal and anterior temporal structures. Coronal and transaxial views (oriented so that the left hemisphere is on the right of the image) also indicate relative frontal-temporal atrophy that is most prominent in the left hemisphere. A three-dimensional reconstruction of her SPECT scan revealed prominet hypoperfusion throughout the left frontal lobe and anterior portions of the temporal lobe on the left sagittal view (leftmost image). An anterior view of her SPECT scan (middle image, oriented so that the left hemisphere is on the right of the image) emphasizes the relative hypoperfusion in the left frontal lobe compared with the right frontal lobe. A sagittal view of the right hemisphere on SPECT scan (rightmost image) reveals right anterior temporal hypoperfusion as well. (Image and patient characterization provided by Dr. Murray Grossman, University of Pennsylvania.)

Neuroimaging - A Companion to Adams and Victor's Principles of Neurology - Greenberg