Clegg, SL

Fox, NC

Malone, IB

Slattery, CF

Warren, JD

PubMed

UCL Discovery

Supplemental dataat Neurology.orgReversible frontotemporal brain saggingsyndromeA 71-year-old man presented with 6 years of forgetfulness, behavioral change, intrusive “growling” vocalizations,orthostatic headaches, and a cough.MRI brain was consistent with frontotemporal brain sagging syndrome (figure, A).He subsequently fell, hitting his chest on a chair, with immediate resolution of his cough, cognitive improvement, andcorresponding radiologic desagging (figure, B; video on the Neurology® Web site at Neurology.org).Frontotemporal brain sagging syndrome may be caused by intracranial hypotension secondary to CSF leak-age along nerve root sleeves and is a potentially treatable frontotemporal dementia mimic.1 In this case, the fallmay have caused a contusion injury and given him an auto-blood patch.Catherine F. Slattery, MA, MRCP, Ian B. Malone, PhD, Shona L. Clegg, BSc, Jason D. Warren, PhD, FRACP,Nick C. Fox, MD, FRCPFrom UCL Institute of Neurology, London, UK.Author contributions: Catherine F. Slattery: reviewed the patient clinically and wrote and redrafted the manuscript. Ian B. Malone:performed nonlinear registration of imaging and redrafted the manuscript. Shona L. Clegg: performed linear registration of imaging andredrafted the manuscript. Jason D. Warren: reviewed the patient clinically and redrafted the manuscript. Nick C. Fox: reviewed thepatient clinically and redrafted the manuscript.Study funding: The Dementia Research Centre is supported by Alzheimer’s Research UK, Brain Research Trust, and The WolfsonFoundation.Disclosure: C. Slattery has received an honorarium payment for speaking to GE Healthcare in 2015. I. Malone and S. Clegg report nodisclosures relevant to the manuscript. J. Warren is funded by a WTSCF grant (091673/Z/10/Z). N. Fox during the last 2 years hasreceived payment for consultancy or for conducting studies from AVID, IXICO, Janssen Alzheimer Immunotherapy, Sanofi-Aventis,Genentech, Novartis, Roche, and Pfizer/Wyeth Pharmaceuticals. Professor Fox has an NIHR Senior Investigator award and receivessupport from the Wolfson Foundation, NIHR Biomedical Research Unit (Dementia) at UCL, the EPSRC, Alzheimer’s Research UK,and the NIA. He receives no personal compensation for the activities mentioned above. Go to Neurology.org for full disclosures. TheArticle Processing Charge was paid by The Wellcome Trust.Correspondence to Dr. Slattery: c.slattery@ucl.ac.ukThis is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permitsunrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.1. Wicklund MR, Mokri B, Drubach DA, Boeve BF, Parisi JE, Josephs KA. Frontotemporal brain sagging syndrome: an SIH-likepresentation mimicking FTD. Neurology 2011;76:1377–1382.Figure Coronal volumetric T1 MRI brain appearances of brain sagging and its resolutionMRI at presentation (A) shows midbrain descent below the tentorium (black arrows) and posterior parahippocampal and lin-gual gyri herniation (white arrows). Follow-up MRI (B) demonstrates restoration of normal brainstem and medial temporallobe configuration.VIDEONEUROIMAGES© 2015 American Academy of Neurology 833ª 2015 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

Reversible frontotemporal brain sagging syndrome

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Reversible frontotemporal brain sagging syndrome

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