R M Yousuf, A R M Fauzi, K. T. Wai, M Amran, SFU Akter, M Ramli
Introduction: Dementia is tragic mind-wrecking disease, defined as a multifaceted decline in cognitive function severe enough to interfere with activities of daily life. Three individual cases are presented that presented with loss of memory and altered behaviour. Even though potentially reversible dementia accounts for a relatively small portion of the total cases of dementia, the three cases presented here demonstrate that accurate and timely diagnosis may greatly improve the condition of the patients, or even restore their normal intellectual function.
Case presentation: Patients 69 year old Malay male and 79 year old Chinese male were brought in to our hospital by their families with history of memory impairment and altered behaviour. The former was diagnosed as left frontoparietal meningioma with possible haemorrhage causing mass effect. The latter was diagnosed as subdural hematoma with midline shift. The former underwent craniotomy and excision of meningioma, and aspiration of an adjacent hemorrhagic cyst. The latter underwent burr-hole craniotomy with closed-system drainage. Following surgery both patients improved with Mini-Mental State Examination levels (MMSE) of 28/30 and 30/30 respectively and in their follow-up were doing well. Third patient, a 50-year-old Chinese lady, had symptoms of forgetfulness and altered behaviour for the past two years, was treated for depression and improved markedly with no more psychotic symptoms.
Conclusion: Chronic subdural hematomas, meningiomas and depression are among the known reversible causes of dementia. Presenting symptoms can be subtle and clinical acumen dictates that all patients should be thoroughly investigated to rule out such possibilities.
