Transient Global Amnesia

Huber, Roman; Aschoff, Andrik J.; Ludolph, Albert C.; Riepe, Matthias W.

doi:10.1007/s00415-002-0881-3

Cited by 54 publications

(22 citation statements)

References 31 publications

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“…To this effect, neuroimaging studies focused on the evaluation of DWI abnormalities in TGA. Different results and interpretations of DWI lesions were given: DWI abnormalities in TGA did not resemble DWI findings in TIA in terms of time course delay, size of lesion and diffusion coefficient values [5,6,7,8,9,10,14]. Moreover, studies supported the hypothesis that vasospasms due to impaired vasoreactivity may trigger TGA [12,13].…”

Section: Discussionmentioning

confidence: 73%

“…DWI detected high signal abnormalities in the medial temporal lobe and in other structures implicated in memory functioning, suggesting a vascular etiology of TGA due to venous ischemia in patients with Valsalva-like activities before symptom onset and to arterial thromboembolic ischemia in patients with carotid atherosclerosis [4]. However, DWI data are still the subject of debate, with some studies reporting DWI abnormalities in a high percentage of cases and others reporting no detectable DWI abnormalities [5,6,7,8,9,10]. Different neuroimaging findings have been conducted to elucidate the different pathogentic mechanisms in patients with TGA.…”

Section: Introductionmentioning

confidence: 99%

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Cerebrovascular Risk Factors and Triggers in Transient Global Amnesia Patients with and without Jugular Valve Incompetence: Results from a Sample of 243 Patients

Agosti

Borroni

Akkawi³

et al. 2010

Eur Neurol

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Background/Aims: Different etiologies for transient global amnesia (TGA) have been proposed, such as venous flow abnormalities, spreading depression and migraine-related mechanisms like focal ischemia. Jugular vein valve incompetence (JVI) is commonly described in TGA patients, but its contributing role in TGA pathogenesis is still unknown. We investigated the possible relationship between JVI and pathogenetic mechanisms in TGA. Methods: 243 TGA patients underwent clinical and neurological assessment. Demographic characteristics, TGA-precipitating factors and vascular comorbidities were carefully recorded. In each patient, JVI was assessed by Doppler ultrasonography. Results: TGA patients were grouped according to the presence (n = 171, 70.4%) or absence (n = 72, 29.6%) of JVI. TGA patients with JVI showed a higher presence of precipitating factors, namely a Valsalva-like maneuver (JVI-positive vs. JVI-negative, 35.8 vs. 17.1%, p = 0.004) and emotional stress (36.6 vs. 21.4%, p = 0.023), but had fewer vascular comorbidities, namely hypertension (37.2 vs. 51.4%, p = 0.047) and carotid arteriosclerosis (20.5 vs. 31.9%, p = 0.050). Conclusions: These findings support the argument for the existence of at least 2 different TGA-associated mechanisms defined by JVI. On the one hand, JVI associated with a Valsalva-like maneuver and emotional stress supported the venous blood congestion hypothesis, and on the other, the JVI-negative group may have another vascular basis, unrelated to venous congestion.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Cerebrovascular Risk Factors and Triggers in Transient Global Amnesia Patients with and without Jugular Valve Incompetence: Results from a Sample of 243 Patients

Agosti

Borroni

Akkawi³

et al. 2010

Eur Neurol

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“…This finding was interpreted as evidence for spreading depression. Other authors reported on TGA patients with multiple DWI lesions in the PCA territory (hippocampus, thalamus, splenium, occipital lobe) [21,22] or only small hippocampal DWI lesions [23], but the question whether these DWI lesions were a typical finding in TGA was not satisfactorily answered, especially so as other authors failed to find similar results [24,25,26]. A large series of TGA patients systematically studied with serial MRI examinations was not published until 2004 [27].…”

Section: Transient Global Amnesiamentioning

confidence: 80%

Diffusion-Weighted Imaging for the Differential Diagnosis of Disorders Affecting the Hippocampus

et al. 2011

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Background: The human hippocampus can be affected in a large variety of very different neurological diseases, of which acute ischemic stroke, transient global amnesia, epilepsy, and limbic encephalitis are the most common. Less frequent etiologies include various infections and encephalopathy of different origins. Clinical presentation notably comprises confusional state, altered vigilance, memory deficits of various extent and seizures. While in hypoxic or hypoglycemic encephalopathy, clinical presentation and surrounding circumstances provide some clues to reach the correct diagnosis, in the above-listed more common disorders, signs and symptoms might overlap, making the differential diagnosis difficult. This review presents recent studies using the diffusion-weighted imaging (DWI) technique in diseases involving the hippocampus. Methods: References for the review were identified through searches of PubMed from 1965 to January 2011. Only papers published in English were reviewed. Full articles were obtained and references were checked for additional material where appropriate. Results: All pathologies affecting the hippocampus are associated with distinct lesion patterns on magnetic resonance imaging, and especially DWI has the ability to demonstrate even minute and transient hippocampal lesions. In acute ischemic stroke in the posterior cerebral artery territory, involvement of the hippocampal formation occurs in four distinct patterns on DWI that can be easily differentiated and correspond to the known vascular anatomy of the hippocampus. In the subacute phase after transient global amnesia (TGA), dot-like hyperintense lesions are regularly found in the lateral aspect of the hippocampus on DWI. The DWI lesions described after prolonged seizures or status epilepticus include unilateral or bilateral hippocampal, thalamic, and cortical lesions of various extent, not restricted to vascular territories. In limbic encephalitis, DWI lesions are only infrequently found and usually affect the hippocampus, uncus and amygdala. Furthermore, in some rare cases DWI lesions of different etiology may coexist. Conclusion: In patients with diseases affecting the hippocampus, DWI appears to be useful in differentiating between underlying pathologies and may facilitate a definite diagnosis conducive to an optimal treatment. With a careful clinical examination, experience with the interpretation of DWI findings and knowledge of associated phenomena, it is indeed possible to differentiate between ischemic, ictal, metabolic, and TGA-associated findings.

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“…Although some studies could not find any abnormal lesions with brain MRI, other recent studies showed small, high-signal intensity lesions in the hippocampus using diffusion weighted imaging (DWI) 3-5,9,10. Based on these imaging findings, the hypoxic ischemic mechanism was considered as a main etiologic factor 2.…”

Section: Introductionmentioning

confidence: 99%

Higher Lesion Detection by 3.0T MRI in Patient with Transient Global Amnesia

et al. 2009

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Purpose: Transient global amnesia (TGA) patients were retrospectively reviewed to determine the usefulness of high-field strength MRI in detecting probable ischemic lesions in TGA. Materials and Methods: We investigated the lesion detection rate in patients with TGA using 1.5T and 3.0T MRI. Acute probable ischemic lesions were defined as regions of high-signal intensity in diffusion weighted image with corresponding low-signal intensity in apparent diffusion coefficient map. Results: 3.0T MRI showed 11 out of 32 patients with probable ischemic lesions in the hippocampus with mean lesion size of 2.8 ± 0.6 mm, whereas 1.5T MRI detected no lesion in any of 11 patients. There were no significant differences in clinical characteristics between the groups of 1.5 and 3.0T MRI. Conclusion: High-field strength MRI has a higher detection rate of probable ischemic lesions than low-field strength MRI in patients with TGA.

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Transient Global Amnesia

Cited by 54 publications

References 31 publications

Cerebrovascular Risk Factors and Triggers in Transient Global Amnesia Patients with and without Jugular Valve Incompetence: Results from a Sample of 243 Patients

Cerebrovascular Risk Factors and Triggers in Transient Global Amnesia Patients with and without Jugular Valve Incompetence: Results from a Sample of 243 Patients

Diffusion-Weighted Imaging for the Differential Diagnosis of Disorders Affecting the Hippocampus

Higher Lesion Detection by 3.0T MRI in Patient with Transient Global Amnesia

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