Case 6-1990

Presentation of Case A 78-year-old man was admitted to the hospital because of confusion, impaired memory, and a gait disturbance. The patient was well and active in business until three months earlier, when he consulted a physician because of a headache and nausea, with increasing confusion, but no explanation was found. Isosorbide, which the patient took because of coronary artery disease, was discontinued, with only transient relief. The patient was referred to a neurologist. A cranial computed tomographic (CT) scan was reported to show only mild cerebral atrophy. The headaches persisted, and vomiting developed, with a loss of 11.4 kg . . .