Frequency of silent brain infarction in transient global amnesia

J Neurol. 2022 Mar;269(3):1422-1426. doi: 10.1007/s00415-021-10705-4. Epub 2021 Jul 17.

Abstract

Background and purpose: To determine the frequency and distribution pattern of acute DWI lesions outside the hippocampus in patients clinically presenting with Transient Global Amnesia (TGA).

Methods: Consecutive patients clinically presenting with TGA between January 2010 and January 2017 admitted to our hospital were retrospectively evaluated. All patients fulfilled diagnostic criteria of TGA. We analyzed imaging and clinical data of all patients undergoing MRI with high-resolution diffusion-weighted imaging within 72 h from symptom onset.

Results: A total of 126 cases were included into the study. Fifty-three percent (n = 71/126) presented with one or more acute lesions in hippocampal CA1-area. Additional acute DWI lesions in other cortical regions were found in 11% (n = 14/126). All patients with DWI lesions outside the hippocampus presented with neurological symptoms typical for TGA (without additional symptoms.) CONCLUSIONS: In a relevant proportion of clinical TGA patients, MRI reveals acute ischemic cerebral lesions. Therefore, cerebral MRI should be performed in patients with TGA to identify a possible cardiac involvement and to detect stroke chameleons.

Keywords: Autonomic nervous system; Brain–heart syndrome; MRI; Transient global amnesia.

MeSH terms

  • Amnesia, Transient Global* / diagnostic imaging
  • Amnesia, Transient Global* / epidemiology
  • Brain Infarction / diagnostic imaging
  • Brain Infarction / epidemiology
  • Brain Infarction / pathology
  • Diffusion Magnetic Resonance Imaging / methods
  • Hippocampus / diagnostic imaging
  • Hippocampus / pathology
  • Humans
  • Retrospective Studies