[Verse 1]
Beneath the skull, a cartograph of change,
White matter hyperintensities arrange
Themselves like scattered archipelagos,
Where vascular damage ebbs and flows.
The FLAIR sequence glows with bright terrain,
Small vessel injury mapped across the brain,
Periventricular lesions, deep and wide,
Executive dysfunction walks beside.
Each lacunar infarct, silent, small,
Accumulates until the scaffolding falls,
Cerebrovascular burden, slow to name,
But cognitive decline is not the same as flame.
[Chorus]
Remember the subtypes, carve them in your mind,
Alzheimer's, Lewy, vascular, frontotemporal kind,
Normal pressure hydrocephalus — a triad to recite:
Gait apraxia, incontinence, cognition losing light —
But wait — this one is reversible, the shunt may set things right,
Four basics of neurology, hold them firm and tight.
[Verse 2]
Now stroke arrives as hemiplegia's thief,
Or aphasia soft, or something brief,
TBI in elders hides behind a fall,
A chronic subdural whispering through the hall.
Dementia pugilistica, the boxer's tax,
Tau proteins folding, neuronal tracks collapse,
And seizures in the aged present strange,
Postictal fog, automatisms rearranged —
No tonic-clonic theater on the floor,
Just transient confusion at the bedroom door,
The clinician must harbor lentitude —
That rarest patience, slow and shrewd to brood.
[Chorus]
Remember the subtypes, carve them in your mind,
Alzheimer's, Lewy, vascular, frontotemporal kind,
Normal pressure hydrocephalus — a triad to recite:
Gait apraxia, incontinence, cognition losing light —
But wait — this one is reversible, the shunt may set things right,
Four basics of neurology, hold them firm and tight.
[Bridge]
Now hear this — hearing loss is not benign,
Untreated presbycusis clouds the mind,
Social withdrawal feeds the cognitive decline,
Auditory deprivation, a slow unraveling vine.
And vision — macular degeneration steals the page,
The older eye reads less, contracts its stage,
Sensory poverty accelerates the age,
So screen the ears and eyes of every sage.
[Verse 3]
Lewy bodies shimmer, fluctuate,
REM behavior disorder seals their fate,
Parkinsonism paired with visual hallucination,
Neuroleptic sensitivity — a dangerous medication station.
Frontotemporal dementia strips the brake,
Disinhibition, apathy in its wake,
Semantic loss, executive erosion,
The personality dissolves like salt in ocean.
Each subtype wears a signature in time,
The clinician must learn to read the paradigm,
Not every fading memory is the same refrain —
Precision is the compass through the aging brain.
[Chorus]
Remember the subtypes, carve them in your mind,
Alzheimer's, Lewy, vascular, frontotemporal kind,
Normal pressure hydrocephalus — a triad to recite:
Gait apraxia, incontinence, cognition losing light —
But wait — this one is reversible, the shunt may set things right,
Four basics of neurology, hold them firm and tight.