PDF(Pubmed)
Abstract：
Transient global amnesia (TGA) is a benign and transient condition with a sudden short-term amnesia. One of the conditions resembling TGA is hippocampal infarction, which requires relapse prevention treatments. In this report, we present a case with bilateral hippocampal infarction in whom distinguishing these two conditions was difficult for up to 1 week from the onset. A 60-year-old female visited our hospital with sudden onset retrograde and anterograde amnesia. Thin-slice magnetic resonance imaging (MRI) with 2-mm thickness revealed hyperintense signals on diffusion-weighted imaging (DWI) with signal loss on apparent diffusion coefficient (ADC) on both sides of the hippocampus. MRI with 5-mm thickness on day 7 revealed persistent restricted diffusion on both sides, one of which was still with decreased ADC values. Based on this finding, the diagnosis of bilateral hippocampal infarction was reached, and the relapse-preventive antiplatelet was continued. This case implied the potential difficulty of distinguishing cases with TGA and those with hippocampal infarction based on MRI findings within the first several days after onset. Thin-slice brain MRI, careful search of potential cardiovascular risks, and follow-up MRI ≥ 7 days after onset will be helpful to reach a correct diagnosis in cases with sudden amnesia.
摘要：
短暂性整体健忘症（TGA）是一种良性和短暂性疾病，伴有突然的短期健忘症。类似于TGA的情况之一是海马梗死，这需要预防复发的治疗。在这份报告中,我们介绍了一个双侧海马梗死的病例，在发病后1周内难以区分这两种情况。一名60岁的女性因突然逆行和顺行性健忘症来我院就诊。厚度为2mm的薄层磁共振成像（MRI）在扩散加权成像（DWI）上显示出高强度信号，海马两侧的表观扩散系数（ADC）信号丢失。第7天厚度为5毫米的MRI显示两侧持续受限扩散，其中之一仍然是ADC值降低。基于这一发现,诊断为双侧海马梗死，并继续预防复发的抗血小板治疗。该病例暗示在发病后的头几天内根据MRI发现区分TGA病例和海马梗死病例的潜在困难。薄层脑MRI,仔细寻找潜在的心血管风险，发病后≥7天的MRI随访将有助于在突发性健忘症的病例中达到正确的诊断。
