Case 158


A 73-year-old male patient, 4 years of schooling, attended a doctor appointment, accompanied by his wife, who reports his behaviour alterations, such as apathy and aggression, as well as memory impairment, psychomotor retardation, gait abnormalities and a 6-month urinary incontinence still in progress. On physical examination: broad-based gait, postural instability and Parkinsonism. Mini-mental state examination (MMSE): 12/30. Laboratory workup for dementia (unchanged exams) and magnetic resonance imaging (MRI) of the brain were requested.

Image 1: MRI of brain in axial section at the level of lateral ventricles.

Considering the images provided and the clinical history, which is the most likely diagnosis?

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