Reversible frontotemporal brain sagging syndrome

A 71-year-old man presented with 6 years of forgetfulness, behavioral change, intrusive “growling” vocalizations, orthostatic headaches, and a cough.MRI brain was consistent with frontotemporal brain sagging syndrome (figure, A). He subsequently fell, hitting his chest on a chair, with immediate resolution of his cough, cognitive improvement, and corresponding radiologic desagging (figure, B; video on the Neurology® Web site at Neurology.org). Frontotemporal brain sagging syndrome may be caused by intracranial hypotension secondary to CSF leakage along nerve root sleeves and is a potentially treatable frontotemporal dementia mimic. In this case, the fall may have caused a contusion injury and given him an auto-blood patch.