Screening for Cognitive Dysfunction Helped to Unmask Silent Cerebrovascular Disease in a Hypertensive Diabetic Patient — Case Report

Journal of Interdisciplinary Medicine

Germán-Salló Márta¹  Preg Zoltán¹  Baróti Beáta²  Tripon Robert Gabriel³  Nemes-Nagy Enikő³ 

[1] Cardiovascular Rehabilitation Clinic, University of Medicine and Pharmacy, Tîrgu Mureș, Romania;Clinic of Radiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania;Department of Biochemistry and Chemistry of Environmental Factors, University of Medicine and Pharmacy, Tîrgu Mureș, Romania;

关键词: cognitive dysfunction;    cerebrovascular disease;    retinopathy;    hypertension;    diabetes mellitus;    retinal imaging;   

DOI  :  10.1515/jim-2017-0037

来源: DOAJ

【 摘 要 】

The current guidelines for the diagnosis and treatment of hypertension recommend screening for cognitive impairment in all hypertensive patients as part of the clinical assessment. However, the implementation of this recommendation in clinical practice is still unsatisfactory. We present the case of an elderly hypertensive female patient in order to highlight the importance of screening for cognitive impairment. A patient with a history of poorly controlled hypertension for the last 12 years and recently diagnosed with type 2 diabetes mellitus is admitted complaining of asthenia, dizziness, visual acuity impairment, and difficulty to remember recent information. Cardiovascular imaging showed 70% internal carotid artery stenosis in a neurologically asymptomatic patient. Cognitive testing showed mild cognitive impairment. Retinal imaging identified stage III hypertensive retinopathy accompanied by irreversible end-organ damage due to microvascular changes. At this point brain MRI was performed, which identified both macro- and microvascular brain lesions in the periventricular white matter and sequelae of a former ischemic stroke in the territory of the left posterior cerebral artery. Cognitive testing helped to unmask silent cerebrovascular disease in an otherwise oligosymptomatic hypertensive diabetic patient. Cognitive function testing should be introduced in routine clinical practice in order to help unmask silent cerebrovascular disease.

【 授权许可】

Unknown