Abstract
Background
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.
Objective
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.
Methods
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.
Results
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%).
Conclusions
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
Abbreviations:
EEG (electroencephalogram), MRI DWI (magnetic resonance imaging diffusion – weighted imaging), TGA (transient global amnesia)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Syndromes of transient amnesia: towards a classification. A study of 153 cases.J Neurol Neurosurg Psychiatry. 1990; 53: 834-843
- Conventional cardiovascular risk factors in Transient Global Amnesia: Systematic review and proposition of a novel hypothesis.Front Neuroendocrinol. 2021; 61100909
- Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus.Cerebrovasc Dis. 2012; 33: 104-115
- Hippocampus in health and disease: An overview.Ann Indian Acad Neurol. 2012; 15: 239-246
- Anatomy of the hippocampal formation. Front Neurol Neurosci.Front Neurol Neurosci. 2014; 34: 6-17
- Surgical anatomy of the hippocampus.Neurochirurgie. 2013; 59: 149-158
- The hippocampus.Am J Neuroradiol. 1993; 14: 709-712
- Structure and vascularization of the human hippocampus.Front Neurol Neurosci. 2014; 34: 18-25
- Transient hippocampal CA1 lesions in humans impair pattern separation performance.Hippocampus. 2019; 29: 736-747
- 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
- Hippocampal modifications in transient global amnesia.Rev Neurol (Paris). 2015; 171: 282-288
Polish National Health Fund reports.
- Diffusion-weighted MRI in transient global amnesia and its diagnostic implications.Neurology. 2020; 14 (95): e206-e212
- Detection of delayed focal MR changes in the lateral hippocampus in transient global amnesia.Neurology. 2004; 22 (62): 2165-2170
- Lesion detectability on diffusion-weighted imaging in transient global amnesia: the influence of imaging timing and magnetic field strength.Neuroradiology. 2012; 54: 329-334
- Comprehensive Ultrasound Assessment of the Craniocervical Circulation in Transient Global Amnesia.J Ultrasound Med. 2018 Feb; 37: 479-486
- Transient global amnesia: a clinical and sonographic study.Eur Neurol. 2003; 49: 67-71
- Transient global amnesia. A case control study.Brain. 1992 Feb; 115 (Pt 1): 261-270
- Long-term outcome in patients with transient global amnesia: a population-based study.Mayo Clin Proc. 2017; 92: 399-405
- Jugular veins in transient global amnesia: innocent bystanders.Stroke. 2012; 43: 2289-2292
- Different risk factor profiles between transient global amnesia and transient ischemic attack: a large case-control study.Eur Neurol. 2014; 71: 19-24
- Transient global amnesia: diffusion-weighted imaging lesions and cerebrovascular disease.Stroke. 2008; 39: 2219-2225
- What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases.Brain. 2006; 129: 1640-1658
- Migraine is associated with a higher risk of transient global amnesia: a nationwide cohort study.Eur J Neurol. 2014; 21: 718-724
- The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up.Brain. 1990; 113: 639-657
- Transient global amnesia and transient ischemic attack.Natural history, vascular risk factors, and associated conditions. Stroke. 1995; 26: 1536-1542
Article info
Publication history
Published online: December 22, 2022
Accepted:
December 18,
2022
Received in revised form:
December 12,
2022
Received:
October 19,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106951
Copyright
© 2022 Elsevier Inc. All rights reserved.