Today, Mom and I sat down with twenty doctors around a conference table at Pitt Memorial Hospital in Greenville, North Carolina. They were neurologists, neurosurgeons and pathologists from East Carolina Neurology and from the Brody School of Medicine at EastCarolinaUniversity. All of us were here for Dr. Frank Fleming’s presentation of my Dad’s case.
One of the doctors gave us the handouts for the presentation – 85 slides! I felt really good that Dr. Fleming had taken my questions on Dad’s dementia and his autopsy report so seriously. But this was the first time I’d been back to Greenville and the hospital where Dad died, and if it was painful for me, it must have been worse for my mother. We agreed that if she got upset, she would step out of the room, and I would stay and take notes.
“OK, let’s get started,” Dr. Fleming said. “Today I’m going to talk about microbleeds and discuss the case of a 73 year old gentleman who unfortunately died of a hemorrhagic stroke in November. Something quite unusual for these Neuroconferences – we have the family here today…”
The first few slides were about Dad’s medical history. He started having problems finding nouns about four years ago. By March 2004, he was having “minor trouble with arithmetic” and had difficulty drawing a clock. Shortly before he died in 2005, he struggled to find any words, and was increasingly confused.
Tests showed my father had normal or low blood pressure, no thyroid problems, no “clinical stroke event.” His cholesterol was low, the arteries in his neck weren’t blocked, and he didn’t have the APOE4 gene associated with a higher risk of Alzheimer’s. In short, there weren’t a lot of clues about what might have caused Dad’s dementia.
“But now we look at these images from his MRI in October 2005,” the doctor said. “You see a dark area on the right side, a spot in the cerebellum here – all these hyperintensities are old hemosiderin deposits.” He was telling us Dad’s brain had been bleeding for a long time.