Research Article| Volume 32, ISSUE 3, 106951, March 2023

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Transient global amnesia - hippocampal lesions in magnetic resonance imaging



      Transient global amnesia is a benign syndrome characterized by a sudden onset loss of anterograde amnesia with full recovery. Magnetic resonance of the brain including diffusion–weighted imaging of patients with transient global amnesia revealed the presence of punctate hyperintense signal abnormalities in the hippocampus.


      Analysis of the presence of hippocampal lesions in brain magnetic resonance imaging in patients with transient global amnesia and the possible influence of additional factors on their appearance.


      In this retrospective, an observational study we assessed brain magnetic resonance imaging in 38 consecutive patients with transient global amnesia. The incidence of brain magnetic resonance imaging lesions was analyzed for the coexisting cardiovascular risk factors and precipitating events.


      Hippocampal brain magnetic resonance imaging lesions were detected in 47% of patients with transient global amnesia. Of those, 65% had unilateral lesions, 82% were left-sided, and 28% were right-sided. Most lesions were located in the CA1 subfield. The incidence of hypertension in patients with transient global amnesia was higher than in the general population. Stress and exercise preceded the onset of transient global amnesia only in 13% and 16% of patients, respectively. There was no higher incidence of migraine in transient global amnesia patients (13%).


      We found that nearly 50% of patients with transient global amnesia had hyperintense hippocampal brain magnetic resonance imaging lesions. In addition to hypertension, individuals with transient global amnesia had similar cardiovascular risk factors as the general population. We did not identify any precipitating events prior to the onset of transient global amnesia.

      Key Words


      EEG (electroencephalogram), MRI DWI (magnetic resonance imaging diffusion – weighted imaging), TGA (transient global amnesia)
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        • Hodges JR
        • Warlow CP.
        Syndromes of transient amnesia: towards a classification. A study of 153 cases.
        J Neurol Neurosurg Psychiatry. 1990; 53: 834-843
        • Liampas I
        • Raptopoulou M
        • Siokas V
        • et al.
        Conventional cardiovascular risk factors in Transient Global Amnesia: Systematic review and proposition of a novel hypothesis.
        Front Neuroendocrinol. 2021; 61100909
        • Förster A
        • Griebe M
        • Gass A
        • et al.
        Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus.
        Cerebrovasc Dis. 2012; 33: 104-115
        • Anand KS
        • Dhikav V.
        Hippocampus in health and disease: An overview.
        Ann Indian Acad Neurol. 2012; 15: 239-246
        • Schultz Ch
        • Engelhardt M
        Anatomy of the hippocampal formation. Front Neurol Neurosci.
        Front Neurol Neurosci. 2014; 34: 6-17
        • Destrieux C
        • Bourry D
        • Velut S.
        Surgical anatomy of the hippocampus.
        Neurochirurgie. 2013; 59: 149-158
        • Mark LP
        • Daniels DL
        • Naidich TP
        The hippocampus.
        Am J Neuroradiol. 1993; 14: 709-712
        • Tatu L
        • Vuillier F.
        Structure and vascularization of the human hippocampus.
        Front Neurol Neurosci. 2014; 34: 18-25
        • Hanert A
        • Pedersen A
        • Bartsch T.
        Transient hippocampal CA1 lesions in humans impair pattern separation performance.
        Hippocampus. 2019; 29: 736-747
        • Strupp M
        • Brüning R
        • Wu RH
        • et al.
        Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients.
        Ann Neurol. 1998; 43: 164-170
        • Quinette P
        • Constans JM
        • Hainselin M
        • et al.
        Hippocampal modifications in transient global amnesia.
        Rev Neurol (Paris). 2015; 171: 282-288
      1. Polish National Health Fund reports.

        • Szabo K
        • Hoyer C
        • Caplan LR
        • et al.
        Diffusion-weighted MRI in transient global amnesia and its diagnostic implications.
        Neurology. 2020; 14 (95): e206-e212
        • Sedlaczek O
        • Hirsch JG
        • Grips E
        • et al.
        Detection of delayed focal MR changes in the lateral hippocampus in transient global amnesia.
        Neurology. 2004; 22 (62): 2165-2170
        • Ryoo I
        • Kim JH
        • Kim S
        • et al.
        Lesion detectability on diffusion-weighted imaging in transient global amnesia: the influence of imaging timing and magnetic field strength.
        Neuroradiology. 2012; 54: 329-334
        • Jovanovic ZB
        • Pavlovic AM
        • Vujisic
        • et al.
        Comprehensive Ultrasound Assessment of the Craniocervical Circulation in Transient Global Amnesia.
        J Ultrasound Med. 2018 Feb; 37: 479-486
        • Akkawi NM
        • Agosti C
        • Anzola GP
        • et al.
        Transient global amnesia: a clinical and sonographic study.
        Eur Neurol. 2003; 49: 67-71
        • Melo TP
        • Ferro JM
        • Ferro H.
        Transient global amnesia. A case control study.
        Brain. 1992 Feb; 115 (Pt 1): 261-270
        • Arena JE
        • Brown RD
        • Mandrekar J
        • et al.
        Long-term outcome in patients with transient global amnesia: a population-based study.
        Mayo Clin Proc. 2017; 92: 399-405
        • Baracchini C
        • Tonello S
        • Farina F
        • et al.
        Jugular veins in transient global amnesia: innocent bystanders.
        Stroke. 2012; 43: 2289-2292
        • Jang JW
        • Park SY
        • Hong JH
        • et al.
        Different risk factor profiles between transient global amnesia and transient ischemic attack: a large case-control study.
        Eur Neurol. 2014; 71: 19-24
        • Enzinger C
        • Thimary F
        • Kapeller P
        • et al.
        Transient global amnesia: diffusion-weighted imaging lesions and cerebrovascular disease.
        Stroke. 2008; 39: 2219-2225
        • Quinette P
        • Guillery-Girard B
        • Dayan J
        • et al.
        What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases.
        Brain. 2006; 129: 1640-1658
        • Lin KH
        • Chen YT
        • Fuh JL
        • et al.
        Migraine is associated with a higher risk of transient global amnesia: a nationwide cohort study.
        Eur J Neurol. 2014; 21: 718-724
        • Hodges JR
        • Warlow CP.
        The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up.
        Brain. 1990; 113: 639-657
        • Zorzon M
        • Antonutti L
        • Masè G
        • et al.
        Transient global amnesia and transient ischemic attack.
        Natural history, vascular risk factors, and associated conditions. Stroke. 1995; 26: 1536-1542