Skip to main content Accessibility help
×
Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-24T12:42:52.767Z Has data issue: false hasContentIssue false

Case 24 - Punch Drunk

from Part 5 - Difficult-to-Characterize Cognitive/Behavioral Disorders

Published online by Cambridge University Press:  03 November 2020

Keith Josephs
Affiliation:
Mayo Clinic Alzheimer’s Disease Research Center
Federico Rodriguez-Porcel
Affiliation:
Medical University of South Carolina
Rhonna Shatz
Affiliation:
University of Cincinnati
Daniel Weintraub
Affiliation:
University of Pennsylvania
Alberto Espay
Affiliation:
University of Cincinnati
Get access

Summary

This 55-year-old left-handed man presented with a 5-year history of progressive behavioral and cognitive decline. Initially, his family noticed he was more withdrawn and irritable. The latter worsened to the point where he exhibited bursts of anger over minor issues. A selective serotonin reuptake inhibitor (SSRI) antidepressant, sertraline, was started and provided moderate benefit. However, over the last two years, he had become distractible, slow in thinking, and increasingly forgetful. These issues affected his performance as an accountant. He had been removed from his responsibilities and assigned to clerical work. He endorsed feeling depressed and anxious. He also complained of a chronic generalized headache, which was moderately relieved by ibuprofen. Before practicing as an accountant, he played rugby professionally for 15 years, retiring at the age of 33. During his career he was knocked unconscious multiple times but reported never having any cognitive or behavioral issues at the time. His father, who also played rugby, was diagnosed with Alzheimer disease at age 65 years.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bonfante, E., Riascos, R. and Arevalo, O. 2018. Imaging of chronic concussion. Neuroimaging Clin N Am 28(1) 127135.CrossRefGoogle ScholarPubMed
Jordan, B. D. 2014. Chronic traumatic encephalopathy and other long-term sequelae. Continuum 20(6) 15881604.Google ScholarPubMed
McKee, A. C. et al. 2016. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathol 131(1) 7586.CrossRefGoogle ScholarPubMed
Montenigro, P. H. et al. 2014. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimers Res Ther 6(5) 68.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×