Acute Amnestic Syndrome and Ischemic Stroke

Abstract

Purposeof Review: Stroke is an uncommon cause of amnesia. We describe in detail three cases of anterograde amnesia and confabulation secondary to acute ischemic stroke and review the available literature.Recent Findings:In our case series, all three patients presented with anterograde amnesia and two of three co-presented with prominent confabulation. These symptoms were recognized in delayed fashion and no patients received IV tPA. Although stroke infarct topology was variable, all three patients had infarction of the fornix. Long-term follow-up was obtained in two of three patients: both had persistent memory impairment and were no longer functionally independent.Summary:Acute onset anterograde amnesia and confabulation may uncommonly represent acute ischemic stroke. Delays in this diagnosis typically exclude patients from emergent stroke treatment or timely diagnostic stroke evaluation. Physicians should maintain a high degree of suspicion, especially in patients with comorbid vascular risk factors. Memory impairment secondary to ischemic stroke can produce considerable long-term disability.

Acute amnestic syndrome in fornix lesions: a systematic review of reported cases with a focus on differential diagnosis

“…The presence of vertigo and right lateral homonymous hemianopsia (due to the concomitant embolic occlusion of left P2-PCA) helped in the diagnosis and localization ( 38 ). Another case, with right fornix and anteromedial right thalamus infarction was attributed to the occlusion of the tubero-thalamic artery due to its peculiar lesions distribution ( 56 ). The memory disturbance was indistinguishable from the other reported cases ( 38 , 56 ).…”

“…Another case, with right fornix and anteromedial right thalamus infarction was attributed to the occlusion of the tubero-thalamic artery due to its peculiar lesions distribution ( 56 ). The memory disturbance was indistinguishable from the other reported cases ( 38 , 56 ).…”

“…Another point that emerges is that, while this syndrome has been previously named “amnestic syndrome of the subcallosal artery” ( 29 ), it can also occur as a consequence of a posterior circulation stroke in exceedingly rare cases ( 38 , 56 ). The presence of neurological deficits typical of posterior circulation involvement as ataxia or visual field deficits point to this uncommon circumstance ( 38 ).…”

Subcallosal Occlusion Following Anterior Communicating Aneurysm Treatment

“…Its occlusion leads to a stereotyped radioclinical image with a Korsakof syndrome and a stroke of the anterior pillars of the fornix. 1,2 Study Funding No targeted funding reported.…”