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HouseDoc, Attending Physician
Category: Medical
Satisfied Customers: 3262
Experience:  Licensed by the State of New York
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ive just found out that the mri of my brain shows bifrontal

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i've just found out that the mri of my brain shows bifrontal atrophy. my neuorologist attributes it to having had Cushing's syndrome (benign adrenal adenoma causing overproduction of cortisol) that went undetected and untreated for over a decade. he gave no explanation of the condition other than it's a shrinking of the brain. HELP! what are the ramifications of this, what can i expect in the future and how serious is this? i am already experiencing loss of memory, cognitive skills, speech issues (nouns pop out of my head just as i'm about to use them) i know i've suffered significant loss of IQ. he gave me a prescription for cerefolin (b12 and folic acid) because i'm low in some amino acid (i think) that starts with homo__?(can't remember). i'm also very low in vitamin D and am now on Rx for that. sorry- i just saw that this is a discussion on concussions -can you address my concerns anyway?
Submitted: 7 years ago.
Category: Medical
Expert:  HouseDoc replied 7 years ago.

Elevated glucocorticoids can cause a decrease in size of the hippocampus (a portion of your temporal lobe responsible for memory). However elevated glucocorticoid levels have NOT been linked to bifrontal atrophy. If you have bifrontal atrophy it is more likely related to age than Cushing's Disease. In patient's with frontal lobe atrophy, dementia is very likely. As such it is important to screen for the cause of dementia such as B12/folate deficiency, low homocysteine levels, and thyroid dysfunction. If your B12 level is low, it is very important to give you a supplement. If you have memory deficits, you can also consider asking your doctor for Aricept and/or Namenda. These are medications that used to treat mild/moderate dementia. It will not improve your memory, but it prevent it from getting any worse very fast. Finally it is very important to have an MRI once a year to determine the progression of the atrophy.


Customer: replied 7 years ago.
my doctor was wrong then to attribute the bifrontal atrophy to cushings. i'm 58 tears old - isn,t this a bit young for dementia? i am low in homocysteine levels and have been prescribed rx of b12 and folic acid
do you still think my age is the reason for the atrophy?
Expert:  HouseDoc replied 7 years ago.

WIth regard to Cusings and Bifrontal Atrophy here is an article from the Journal of Clinical Neuroscience to back up what I said: doi:10.1016/j.jocn.2008.12.026


In terms of dementia, this can happen at relatively young age. The amount dementia depends on the level of atrophy and what areas of the brain showing atrophy. Patients with fronto-temporal atrophy can demonstrate the type of symptoms that you have mentioned. It is not age alone that lead to atrophy. Atrophy can also occur because of environmental factors as well as because of genetic reasons.


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