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Hippocampal infarction: redefining transient global amnesia

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Abstract

Background and aims

Transient global amnesia (TGA) is a clinical syndrome characterized by sudden anterograde amnesia not accompanied by other neurological symptoms. There is no consensus on the underlying pathophysiological mechanism. However, diffusion-weighted imaging (DWI) of the magnetic resonance imaging (MRI) has demonstrated hippocampal lesions in as many as 50% of cases. This paper describes a series of patients with TGA and hippocampal lesions.

Methods

This study assessed vascular risk factors in patients older than age 18 admitted to the Hospital Universitario San Ignacio, Bogota, Colombia, from May 2017 to June 2020 with a diagnosis of TGA and evidence of hippocampal ischemic lesion on 3 Tesla brain MRI.

Results

The authors identified 36 patients, 72.2% female, with mean age 62 years. Cardiovascular risk factors, most frequently high blood pressure, carotid disease, and dyslipidemia, were present in 75% of these patients. Hippocampal lesions were unilateral in 80% of cases, with median size 2.5 mm, most frequently located at the hippocampal body. Approximately 14% of patients also presented acute ischemic lesions in locations other than the hippocampus.

Conclusions

TGA is a clinical entity previously considered to have undetermined etiology. The present study used brain MRI to identify a group of patients with hippocampal ischemic lesions, finding associated vascular risk factors in a high proportion of them.

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References

  1. Arena JE, Rabinstein AA (2015) Transient global amnesia. Mayo Clin Proc 90(2):264–272

    Article  Google Scholar 

  2. Hodges JR, Warlow CP (1990) The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up. Brain 113:639–657

    Article  Google Scholar 

  3. Williamson J, Larner AJ (2015) Transient global amnesia. Br J Hosp Med 76(12):C186–C188

    Article  Google Scholar 

  4. Hodges JR, Warlow CP (1990) Syndromes of transient amnesia: towards a classification. A study of 153 cases. Journal of Neurology, Neurosurgery and Psychiatry 53(10):834–843

    Article  CAS  Google Scholar 

  5. Sander K, Sander D (2005) New insights into transient global amnesia: recent imaging and clinical findings. Lancet Neurol 4:437

    Article  Google Scholar 

  6. Quinette P, Guillery-Girard B, Dayan J et al (2006) What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 129:1640

    Article  Google Scholar 

  7. Förster A, Al-Zghloul M, Wenz H, Böhme J, Groden C, Neumaier-Probst E (2016) Isolated punctuate hippocampal infarction and transient global amnesia are indistinguishable by means of MRI. Int J Stroke 12(3):292–296

    Article  Google Scholar 

  8. Miller JW, Petersen RC, Metter EJ et al (1987) Transient global amnesia: clinical characteristics and prognosis. Neurology 37:733

    Article  CAS  Google Scholar 

  9. Goff D, Lloyd-Jones D, Bennett G, Coady S, D’Agostino R, Gibbons R et al (2014) 2013 ACC/AHA Guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation (New York N.Y.) 129(25_suppl_2 Suppl 1):S49–S73

    Google Scholar 

  10. Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA (1987) MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. American journal of roentgenology (1976) 149(2):351–356

    Article  CAS  Google Scholar 

  11. Bartsch T, Deuschl G (2010) Transient global amnesia: functional anatomy and clinical implications. The Lancet Neurology 9(2):205–214

    Article  Google Scholar 

  12. Michael E Mahler. MD. Transient global amnesia. In: UpToDate, Post TW (Ed), UpToDate, Waltham

  13. Nehring SM, Spurling BC, Kumar A (2020) Transient global amnesia. [Updated 2020 Jul 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing

  14. Koski KJ, Marttila RJ (1990) Transient global amnesia: incidence in an urban population. Acta Neurol Scand 81:358

    Article  CAS  Google Scholar 

  15. Oehler E, Iaxx F, Larre P, Ghawche F (2015) Transient global amnesia: a descriptive study of 12 Polynesian patients. Revue neurologique 171(8–9):662–668

    Article  CAS  Google Scholar 

  16. Jain T, Patel R, Gawarikar Y (2018) Transient global amnesia: diffusion MRI findings. The Indian journal of radiology & imaging 28(1):6–9

    Article  Google Scholar 

  17. Speigel DR, Mccroskey AL, Deyerle BA (2016) A case of transient global amnesia: a review and how it may shed further insight into the neurobiology of delusions. Innov Clin Neurosci 13:32–41

    Google Scholar 

  18. Renato Oliveira, Tomás Teodoro, Inês Brás Marques (2020) Risk factors predicting recurrence of transient global amnesia. Neurol Sci

  19. Waliszewska-Prosol M, Nowakowska-Kotas M, Bladowska J, Papier P, Budrewicz S, Pokryszko-Dragan A (2020) Transient global amnesia - risk factors and putative background. Neurol Ind 68(3):624–629

  20. Yi M, Sherzai AZ, Ani C et al (2019) Strong association between migraine and transient global amnesia: a national inpatient sample analysis. J Neuropsychiatry Clin Neurosci 31:43

    Article  Google Scholar 

  21. Bartsch T, Alfke K, Stingele R et al (2006) Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 129:2874

    Article  CAS  Google Scholar 

  22. Arena JE, Brown RD, Mandrekar J, Rabinstein AA (2017) Long-term outcome in patients with transient global amnesia: a population-based study. Mayo Clin Proc 92:399

    Article  Google Scholar 

  23. Jang JW, Park SY, Hong JH et al (2014) Different risk factor profiles between transient global amnesia and transient ischemic attack: a large case-control study. Eur Neurol 71:19

    Article  Google Scholar 

  24. Pantoni L, Bertini E, Lamassa M, Pracucci G, Inzitari D (2005) Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study. Eur J Neurol 12(5):350

    Article  CAS  Google Scholar 

  25. Romoli M, Tuna M, McGurgan I, Li L, Giannandrea D, Eusebi P et al (2019) Long-term risk of stroke after transient global amnesia in two prospective cohorts. Stroke (1970) 50(9):2555–2557

    Article  Google Scholar 

  26. Morris KA, Rabinstein AA, Young NP (2020) Factors associated with risk of recurrent transient global amnesia. JAMA Neurol 77(12):1551–1558

    Article  Google Scholar 

  27. Lewis SL (1998) Aetiology of transient global amnesia. The Lancet (British edition) 352(9125):397–399

    CAS  Google Scholar 

  28. Auyeung M, Tsoi TH, Cheung CM, Fong DYT, Li R, Chan JKW et al (2010) Association of diffusion weighted imaging abnormalities and recurrence in transient global amnesia. J Clin Neurosci 18(4):531–534

    Article  Google Scholar 

  29. Memory diseases and conditions - transient global amnesia (2020) Studies from Vittorio Govoni and Co-Authors Have Provided New Information about Transient Global Amnesia (The distribution of the transient global amnesia in the province of Ferrara, Italy, a clue to the pathogenesis?). Pain & central nervous system week :7198

  30. Schneckenburger R, Hainselin M, Viader F, Eustache F, Quinette P (2020) Serum cortisol levels in patients with a transient global amnesia. Revue neurologique 176(4):285–288

    Article  CAS  Google Scholar 

  31. Griebe M, Ebert A, Nees F, Katic K, Gerber B, Szabo K (2019) Enhanced cortisol secretion in acute transient global amnesia. Psychoneuroendocrinology 99:72–79

    Article  CAS  Google Scholar 

  32. Bermejo-Velasco PE, Castillo-Moreno L, Escamilla-Crespo C (2006) Transient global amnesia associated to hypopotassemia. Rev Neurol. 42(4):255–6 (Spanish)

    CAS  PubMed  Google Scholar 

  33. Alessandro L, Calandri IL, Suarez MF, Heredia ML, Chaves H, Allegri RF et al (2019) Transient global amnesia: clinical features and prognostic factors suggesting recurrence. Arq Neuropsiquiatr 77(1):3–9

    Article  Google Scholar 

  34. Jin R, Yang G, Li G (2010) Inflammatory mechanisms in ischemic stroke: role of inflammatory cells. J Leukoc Biol 87(5):779–789

    Article  CAS  Google Scholar 

  35. Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S et al (2008) Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke 39(2):355–360

    Article  Google Scholar 

  36. Jeong M, Jin J, Kim JH, Moon Y, Choi JW, Kim HY (2017) Incidental hippocampal hyperintensity on diffusion-weighted mri: individual susceptibility to transient global amnesia. The Neurologist (Baltimore, Md) 22(4):103–106

    Google Scholar 

  37. Choi BS, Kim JH, Jung C, Kim SY (2012) High-resolution diffusion-weighed imaging increases lesion detectability in patient with transient global amnesia. AJNR Am J Neuroradiol 33:1771–1774

    Article  CAS  Google Scholar 

  38. Vella S, Grech R (2020) Highlighting the classical MRI findings in transient global amnesia. BJR case reports 6(2):20190111

    Article  Google Scholar 

  39. Higashida K, Okazaki S, Todo K, Sasaki T, Ohara N, Kohara N et al (2020) A multicenter study of transient global amnesia for the better detection of magnetic resonance imaging abnormalities. Eur J Neurol 27(11):2117–2124

    Article  CAS  Google Scholar 

  40. Kim BJ, Lee SH (2015) Prognostic impact of cerebral small vessel disease on stroke outcome. J Stroke 17:101–110

    Article  Google Scholar 

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Acknowledgements

To Dr. Diego Miguel Rivera — Neuro-radiologist, who contributed with interpretation of diagnostic images.

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Authors and Affiliations

  1. Hospital Universitario San Ignacio, Bogotá, D.C, Colombia

    Julián Santana, Carolina García-Alfonso, Andrea Martínez & Juliana Coral

  2. Pontificia Universidad Javeriana, Bogotá, D.C, Colombia

    Julián Santana, Carolina García-Alfonso, Andrea Martínez, Andrés Felipe Cárdenas-Cruz, María Paula Aguilera-Pena, Óscar Bris-Fernández, Alan Waich, María Del Mar Talero- Munoz & Juliana Coral

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  1. Julián Santana
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Correspondence to Julián Santana.

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Santana, J., García-Alfonso, C., Martínez, A. et al. Hippocampal infarction: redefining transient global amnesia. Neurol Sci 43, 4281–4286 (2022). https://doi.org/10.1007/s10072-022-05980-6

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  • DOI: https://doi.org/10.1007/s10072-022-05980-6

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