Early-onset dementia?

[ontherecord]

I am 26, male, and last summer I sustained a sports-related head injury which seems to have left a persistent mild cognitive impairment which somewhat resembles dementia (mild confusion without the apparent forgetfulness).  However, although painful, I did NOT have the classic symptoms, including amnesia, headache, CSF discharge, nausea or vomiting.  In the absence of these accompanying symptoms, and in the absence of structural damage, I am wondering whether a head injury can cause permanent cognitive difficulty? And can someone predict whether this cognitive difficulty will progress, get better, or stay the same? Essentially, can physiologic (as compared to structural) damage be detected on MRI or CT? Or just on neuropsychological testing?

Second, I used a mild dose of alprazolam (.25 mg, TID) for approximately 1 year before discontinuing.  I have read that long-term benzodiazepine use can cause brain shrinkage/enlarged CSF spaces, and I am wondering whether this mild dose which I took could have either caused, or have contributed to this mild cognitive difficulty I am having.  Essentially, can one year of mild benzo use cause or precipitate early-onset dementia, of any sort?

Third, for approximately 3.5 out of the last 8 years (on and off) I have drank heavily (but no longer do today).   I am wondering what type of alcohol use and for what duration can cause cognitive impariment and alcohol-related dementia (outside of Wernicke-Korsakoff syndrome).  Essentially, can 3 or 4 years of heavy drinking in one's twenties cause permanent, irreversible brain damage?

[taazz]

hello everyone

i am 44 years old male. i have had head injuries and now have confusion,depression,and memory loss fro several years now.
lately i have had also longer manic periods....well only say manic cause someone said it sounded like it. well i am actually having this possible manic feeling as i type this
i have also been drinking coffee which i have not had in a wwwhile. my question i guess is ....
can head injury lead to manic feelings ?
can coffee cause it over years and trigger it?

shayne babineau
thanx

[CCF-Neuro-M.D.-CS]

Even though you did not have significant external trauma that,  does not rule out the possibility of internal damage in the brain. Typically loss of consciousness or amnesia are used as indicators of significant head trauma. This is why certain athletes are "forced" to retire after mulitple concussions. A good quality MRI of the brain is a good starting point to evaluate for a structural cause. However the MRI will only tell you about the structure and not the function. Other functional tests which may also be helpful include a FDG-PET scan (measures how the brain uses sugar), and neuropsychological testing. These tests assess brain function more then structure. To have this evalauted formerly, I would recommend seeing a dementia or cognitive specialist at an academic center. Depending on what the evaluation reveals a prognosis can be provided.

Regarding the concern over benzodiazepine use. The recent studies I found on this topic suggest that there is no difference between controls and patients using benzodiazepines.

Regarding the concern over alcohol use. I could find no study which addressed your question directly. At this time the current evidence states that social drinking does not increase your risk of future cognitive decline, and may actually reduce it. However we know that alcoholics can develop Wernicke-Korsakoff syndrome over time. However, this is related to excessive alcohol use without proper nutrition (absence of thiamine). Therefore, I would recommend avoidance of excessive alcohol use at this time. Sorry I could not be more specific.

Good luck.