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Symptoms may resolve in as little as two weeks, or persist for months. [32] Less commonly, patients may have unremitting symptoms for many years. [23] [32] [42] [57] People with chronic sCSFLS may be disabled and unable to work. [24] [28] Recurrent CSF leak at an alternate site after recent repair is common. [88]
Atrophy of any tissue means a decrement in the size of the cell, which can be due to progressive loss of cytoplasmic proteins. In brain tissue, atrophy describes a loss of neurons and the connections between them. Brain atrophy can be classified into two main categories: generalized and focal atrophy. [2]
More recent MRI studies have reported age-related regional decreases in cerebral volume. [6] [7] Regional volume reduction is not uniform; some brain regions shrink at a rate of up to 1% per year, whereas others remain relatively stable until the end of the life-span. [8]
Of those who have residual symptoms after PRES, this is attributable largely to hemorrhage. [1] [4] Non-resolution of MRI abnormalities has been linked with poorer outcomes. [4] The presence of brain hemorrhage and cytotoxic edema (brain edema with concomittant brain tissue damage) is also associated with a poor prognosis. [2]
Dementia-like symptoms have been found in some individuals who have been exposed to glucocorticoid medication, often dispensed in the form of asthma, arthritis, and anti-inflammatory steroid. [2] The term "steroid dementia" was coined by Varney et al. (1984) in reference to the effects of long-term glucocorticoid use in 1,500 patients. [3]
MRI image: Leukoaraiosis in a 90-year-old patient with cerebral atrophy. Head CT showing periventricular white matter lesions. Leukoaraiosis is a particular abnormal change in appearance of white matter near the lateral ventricles. It is often seen in aged individuals, but sometimes in young adults.
Patients with cerebellar degeneration experience a progressive loss of nerve cells (Purkinje cells) throughout the cerebellum. As well as this, it is common to incur an elevated blood protein level and a high volume of lymph cells within the cerebrospinal fluid , resulting in swelling and enlargement of the brain.
Each case was similar to the previous article. There was some atheroma in the internal brain arteries that led to the cerebral softening of the left side of the brain around the left lateral ventricle, thalamus and corpus striatum. There were similar right sided numbness in some patients, coldness of the extremities, and impairments in vision.