CC BY-NC-ND 4.0 · J Neurosci Rural Pract 2017; 08(S 01): S102
DOI: 10.4103/jnrp.jnrp_202_17
Images in Neurosciences
Journal of Neurosciences in Rural Practice

Transient Global Amnesia

V. Sivakumar
1  Department of MR Imaging, Gemini Scans, Chennai, India
2  Department of Radiodiagnosis, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamil Nadu, India
,
Venkatraman Indiran
3  Department of Radiodiagnosis, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
› Author Affiliations
Further Information

Address for correspondence:

Dr. Venkatraman Indiran
Department of Radiodiagnosis, Sree Balaji Medical College and Hospital
7 Works Road, Chromepet, Chennai, Tamil Nadu
India   

Publication History

Publication Date:
03 September 2019 (online)

 

A 65-year-old afebrile female patient was brought to magnetic resonance imaging (MRI) suite, with a history of memory loss for the past 8 h. She spoke fluently but could not recognize her family members and kept asking about her whereabouts. Her neurological examination was otherwise unremarkable. She did not have a history of epilepsy, stroke, similar past episodes, hypertension, dyslipidemia, diabetes, or smoking. Laboratory testing (blood counts, biochemistry, and electrolytes) and electrocardiogram were normal. MRI showed punctuate nearly symmetrical hyperintense foci showing restricted diffusion in the bilateral hippocampal region on diffusion-weighted imaging (DWI) [[Figure 1a and b]]. Rest of the sequences showed no demonstrable findings. Carotid Doppler and echocardiogram were unremarkable. She recovered spontaneously 24 h after onset of clinical symptoms but was not able to remember events during the period. Diagnosis of transient global amnesia (TGA) was considered. MRI with DWI repeated after 10 days showed no abnormality [[Figure 1c]].

Zoom Image
Figure 1: Axial diffusion-weighted magnetic resonance imaging image (diffusion-weighted imaging) showed punctuate nearly symmetrical hyperintense foci showing restricted diffusion in the bilateral hippocampal region (a and b). Diffusion-weighted imaging repeated after 10 days showed no abnormality (c)

TGA is characterized by acute onset reversible memory disturbances (usually within 24 h) without alteration of consciousness or personal identity. Possible hypothesis includes ischemia, epilepsy, migraine, and emotional stress.[[1]] DWI usually shows restricted punctate foci in CA1 region in the hippocampus.[[1] [2]] Abnormalities in DWI are highly variable in TGA cases (0%–84%), but it has a benign outcome and does not require any treatment.[[1]] However, restricted punctate foci in CA1 region in the hippocampus in appropriate clinical setting of anterograde amnesia are a very good pointer toward TGA.

Financial support and sponsorship

Nil


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Conflicts of interest

There are no conflicts of interest.


Address for correspondence:

Dr. Venkatraman Indiran
Department of Radiodiagnosis, Sree Balaji Medical College and Hospital
7 Works Road, Chromepet, Chennai, Tamil Nadu
India   


Zoom Image
Figure 1: Axial diffusion-weighted magnetic resonance imaging image (diffusion-weighted imaging) showed punctuate nearly symmetrical hyperintense foci showing restricted diffusion in the bilateral hippocampal region (a and b). Diffusion-weighted imaging repeated after 10 days showed no abnormality (c)