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Hippocampal abnormalities in transient Global amnesia
Visual Journal of Emergency Medicine 7 (2017) 44
Contents lists available at ScienceDirect
Visual Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/visj
Visual Case Discussion
Hippocampal abnormalities in transient Global amnesia a,⁎
MARK
b
Hyun-Chul Danny Lee , Joel Levis a
Stanford/Kaiser Emergency Medicine Residency, Palo Alto, CA, USA Department of Emergency Medicine, Kaiser Santa Clara Medical Center, Clinical Assistant Professor (Affiliate) of Emergency Medicine, Stanford University, School of Medicine, United States b
A R T I C L E I N F O Keywords: Transient global amnesia TGA MRI DWI-MRI Hippocampus
A 49-year-old female presented with sudden memory loss. Neurological examination was notable for an inability to recall recent events. A non-contrast CT scan of her brain and CT angiogram of her head and neck were unremarkable. An MRI of her brain was notable for small foci of reduced diffusion in the bilateral hippocampal bodies
on diffusion-weighted imaging (DWI), confirming the diagnosis of transient global amnesia (TGA). TGA is an uncommon neurologic phenomenon with an obscure etiology. Patients will classically present with self-limited, anterograde amnesia and repetitive questioning without other neurologic findings or symptoms. There is no specific treatment, and the prognosis is generally benign (Zorson et al., 1995). Interestingly, this disorder has been correlated with hippocampal abnormalities on DWI-MRI imaging (Sander and Sander, 2005). Our patient was discharged from the ED after symptom resolution, and remained asymptomatic at follow up (Fig. 1).
Appendix A. Supplementary material Supplementary data associated with this article can be found in the online version at http://dx.doi.org/10.1016/j.visj.2017.01.009. References
Fig. 1. DWI-MRI image of the brain from a 49-year-old female with sudden memory loss, demonstrating bilateral focal hippocampal lesions (arrows), consistent with TGA.
⁎
Sander Kerstin, Sander Dirk. New insights into transient global amnesia: recent imaging and clinical findings. Lancet Neurol.. 2005;4(7):437–444. http://dx.doi.org/10.1016/ S1474-4422(05)70121-6 [July]. Zorzon M, Antonutti L, Masè G, Biasutti E, Vitrani B, Cazzato G. transient Global amnesia and transient ischemic attack. natural history, vascular risk factors, and associated conditions. Stroke; a J. Cereb. Circ.. 1995;26(9):1536–1542 [September].
Corresponding author. E-mail address: [email protected] (H.-C. Danny Lee).
http://dx.doi.org/10.1016/j.visj.2017.01.009 Received 20 August 2016; Received in revised form 11 November 2016; Accepted 5 January 2017 2405-4690/ © 2017 Elsevier Inc. All rights reserved. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Contents lists available at ScienceDirect
Visual Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/visj
Visual Case Discussion
Hippocampal abnormalities in transient Global amnesia a,⁎
MARK
b
Hyun-Chul Danny Lee , Joel Levis a
Stanford/Kaiser Emergency Medicine Residency, Palo Alto, CA, USA Department of Emergency Medicine, Kaiser Santa Clara Medical Center, Clinical Assistant Professor (Affiliate) of Emergency Medicine, Stanford University, School of Medicine, United States b
A R T I C L E I N F O Keywords: Transient global amnesia TGA MRI DWI-MRI Hippocampus
A 49-year-old female presented with sudden memory loss. Neurological examination was notable for an inability to recall recent events. A non-contrast CT scan of her brain and CT angiogram of her head and neck were unremarkable. An MRI of her brain was notable for small foci of reduced diffusion in the bilateral hippocampal bodies
on diffusion-weighted imaging (DWI), confirming the diagnosis of transient global amnesia (TGA). TGA is an uncommon neurologic phenomenon with an obscure etiology. Patients will classically present with self-limited, anterograde amnesia and repetitive questioning without other neurologic findings or symptoms. There is no specific treatment, and the prognosis is generally benign (Zorson et al., 1995). Interestingly, this disorder has been correlated with hippocampal abnormalities on DWI-MRI imaging (Sander and Sander, 2005). Our patient was discharged from the ED after symptom resolution, and remained asymptomatic at follow up (Fig. 1).
Appendix A. Supplementary material Supplementary data associated with this article can be found in the online version at http://dx.doi.org/10.1016/j.visj.2017.01.009. References
Fig. 1. DWI-MRI image of the brain from a 49-year-old female with sudden memory loss, demonstrating bilateral focal hippocampal lesions (arrows), consistent with TGA.
⁎
Sander Kerstin, Sander Dirk. New insights into transient global amnesia: recent imaging and clinical findings. Lancet Neurol.. 2005;4(7):437–444. http://dx.doi.org/10.1016/ S1474-4422(05)70121-6 [July]. Zorzon M, Antonutti L, Masè G, Biasutti E, Vitrani B, Cazzato G. transient Global amnesia and transient ischemic attack. natural history, vascular risk factors, and associated conditions. Stroke; a J. Cereb. Circ.. 1995;26(9):1536–1542 [September].
Corresponding author. E-mail address: [email protected] (H.-C. Danny Lee).
http://dx.doi.org/10.1016/j.visj.2017.01.009 Received 20 August 2016; Received in revised form 11 November 2016; Accepted 5 January 2017 2405-4690/ © 2017 Elsevier Inc. All rights reserved. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).