Question normal

Labs:
The patient had normal values for complete blood count and comprehensive metabolic panel. The erythrocyte sedimentation rate was 2 mm per hour; C-reactive protein was within the normal range. Autoimmune screening revealed negative antinuclear antibodies and normal complement levels for C3 and C4.

She had normal levels of serum vitamin B12, folic acid, thyroid-stimulating hormone, and thyroid hormone level.

Imaging
Magnetic Resonance Imaging of the Brain
Fluid-attenuated inversion recovery (FLAIR) images of the sagittal (Panel A) and axial (Panel B) planes show marked atrophy of the frontal and parietal lobes. A contrast-enhanced magnetic resonance imaging (MRI) of the brain revealed severe cortical atrophy of the frontal and parietal lobes, mainly on the right hemisphere (see figure).

Tests
Cerebrospinal fluid (CSF) protein levels and glucose were normal. The CSF-VDRL (venereal disease research laboratory) and serum FTA-ABS (fluorescent treponemal antibody absorption) test were both nonreactive. ELISA (Enzyme-linked immunosorbent assay) for HIV antibodies was negative.

MRI:
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Magnetic Resonance Imaging of the Brain: Fluid-attenuated inversion recovery (FLAIR) images of the sagittal (Panel A) and axial (Panel B) planes show marked atrophy of the frontal and parietal lobes. Courtesy of Jaime Toro, MD.