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Gait disorder and cognitive impairment in an elderly patient
  1. Vincenzo Sidoti1,
  2. Maria Dieli2,
  3. Lorenzo Lorusso3,
  4. Piercarlo Pelizzari4
  1. 1
    Mellino Mellini Hospital, Neurology, viale Mazzini 6, Chiari, 25032, Italy
  2. 2
    Ospedali Riuniti, Internal Medicine, largo Barozzi, 11, Bergamo, 24128, Italy
  3. 3
    Mellini Hospital, 25032, Chiari, 25032, Italy
  4. 4
    ASL Brescia, Adro, Adro, 25032, Italy
  1. Vincenzo Sidoti, VincenzoSidoti{at}hotmail.com

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A 80-year-old man was evaluated in a neurologic department for a gait disorder and a progressive cognitive impairment dating back about 6 months earlier. His pathologic history was unremarkable, except for a minor head injury 6 months before. The neurologic examination revealed neuropsychologic impairment of frontal type, a bilateral Babinsky and an ataxic–apraxic gait with frequent freezings. He also complained about a new onset bladder incontinence. An electroencephalogram showed a slow bi-hemispheric activity. Cranial computed tomography (CT) scan revealed bilateral chronic subdural haematoma with a notable compression of the brain (figs 1 and 2). The patient was successfully treated with surgical drainage of the subdural haematomas, and recovered fully from the disturbances.

Figure 1

Coronal computed tomography (CT) scan of the brain showing a bilateral subdural chronic haematoma up to the convexity.

Figure 2

Coronal CT scan of the brain showing a bilateral subdural chronic haematoma up to the convexity.

This case emphasises the importance of a detailed case history, follow-up of elderly patients after a cranial injury, and the use of CT scan to exclude reversible causes of gait disorder or cognitive impairment.1,2

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Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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