Portosystemic Shunt Presenting as Rapidly Progressive Dementia.

Rapidly progressive dementia (RPD) is a challenging clinical problem in the elderly. It encompasses a wide range of diseases. Thorough clinical examination and a systematic approach is essential to find the cause of RPD. Early recognition of causes of RPD is important for early treatment and reversal of the pathology. We report a case of RPD due to portosystemic encephalopathy secondary to a large portosystemic shunt with preserved liver functions, in a previously healthy elderly male. He had pallidal hyperintensities on MRI brain that can be the clue to the diagnosis of portosystemic shunt and chronic liver disease in patients with RPD.