Rapidly progressive dementia: an unusual cause

Brain metastases are known to be present with a history of increased intra-cranial pressure headache, seizures or altered sensorium. Corresponding to the clinical brain metastases are the most feared complication of a systemic cancer. Classically, brain metastases are associated with significant morbidity and are known to present with a history of increased intracranial pressure headache, seizures or altered sensorium. Neuroimaging is usually suggestive of massive peri-lesional edema and mass effect surrounding the space occupying lesions. This, however it is not a universal rule. We report a 50-year-old gentleman who presented with rapidly progressive forgetfulness. Interestingly, the patient's neuroimaging discretely showed disproportionate involvement with regards to the clinical picture. The lesions were finally recognized as metastases underscoring the importance of an avid search for a primary systemic malignancy if similar findings are noted on radiology.