Transient Global Amnesia After Cerebral Angiography With Iomeprol: A Case Report

Transient Global Amnesia - Risk Factors and Putative Background

Objectives

Transient global amnesia (TGA) is a temporary short-term reversible memory loss. Etiology of TGA remains unclear with various hypotheses. We analyzed clinical characteristics, neuroimaging, and electrophysiological findings as well as comorbidities and seasonal variation in TGA patients with regard to possible background of the syndrome.

Materials and Methods

A total of 56 patients (42 women and 14 men) with TGA hospitalized from 2008 to 2016 in the Department of Neurology, Wrocław Medical University.

Results

A total of 52 patients (92.9%) underwent their first-ever episode of TGA. The potential triggers or events before episode could be recognized in 22 patients (39.3%). 35.7% patients had TGA in summer and 26.8% in winter months. In 92.9% patients chronic diseases were found, included: Hypertension (60.7%), dyslipidemia (48.2%), autoimmune thyroiditis (17.9%), and ischemic heart disease (14.3%). One patient (1,8%) suffered from migraine. Doppler ultrasonography of carotid arteries revealed abnormalities in 29 patients (51.8%). Electroencephalography abnormalities were observed in 10 (17.6%) of patients.

Conclusion

Our findings suggest a putative cerebrovascular background of transient global amnesia. No evidence has been provided for the association between TGA and epilepsy or migraine. Among comorbidities, autoimmune thyroiditis deserves further investigation with regard to its potential links with TGA.

Transient global amnesia after radiofrequency catheter ablation of supraventricular tachycardia: a case report

Transient global amnesia (TGA) is a neurological disorder characterized by sudden onset of anterograde amnesia with or without retrograde amnesia, lasting less than 24 hours, without other clinical neurological dysfunction. TGA with short duration and benign prognosis is usually neglected in clinical practice. Transient total amnesia after radiofrequency ablation is rare and its etiology is unknown. We report a case of 27-year-old man who experienced TGA after radiofrequency catheter ablation of supraventricular tachycardia. The patient had no other cognitive and motor impairment except for memory impairment. The symptom lasted for about six hours and relieved without recurrence. Nervous system examination showed that 12 pairs of cranial nerves were normal, the muscle strength and muscle tone of the limbs were normal, physiological reflexes existed, and no pathological reflexes were elicited. Tests were performed immediately and normally including blood routine examination, liver and kidney function, electrolyte, blood glucose, thyroid function, blood coagulation function, D-dimer, myocardial injury markers, blood gas analysis and other hematological. There is no abnormality in electrocardiogram (ECG), chest X-ray, cervical vascular ultrasound, and cardiac color Doppler ultrasound examination. Head magnetic resonance examination magnetic resonance imaging (MRI) showed dots in right frontal lobe and bilateral ventricles in T2-weighted images. There was no cerebral infarction and cerebral hemorrhage. The patient received low flow oxygen inhalation and aspirin 300mg orally. The outcome of patient with TGA is benign. There are still many unsolved mysteries worthy of long-term follow-up.

Transient global amnesia following carotid artery stenting: A case report

Transient global amnesia (TGA) is a neurological disorder characterized by sudden onset of anterograde and retrograde amnesia. TGA following angiography is rare and its possible etiologies have not been determined definitively. Herein, I report a case of TGA after carotid artery stenting with DWI findings, which, to date, has not been reported. The patient was a 71-year-old man who developed TGA following carotid artery stenting. Diffusion-weighted imaging demonstrated a focal restricted diffusion lesion in the left medial temporal lobe. Left carotid artery stenting was performed via the common femoral artery, and the procedural course was uneventful. However, the patient suffered an amnestic event 1 hour after the procedure. DWI performed 1 hour after amnesia onset revealed a small punctate restricted diffusion lesion in the left hippocampus. One day later, his amnesia spontaneously resolved. Although TGA after endovascular procedure is rare and usually has a favorable prognosis, clinicians and interventionists should be aware of this rare complication.

Simultaneous transient global amnesia and Takotsubo syndrome after death of a relative: a case report

Introduction

Simultaneous occurrence of transient global amnesia and Takotsubo syndrome has been only rarely reported. Here we report another patient with a transient global amnesia and concomitant Takotsubo syndrome.

Case presentation

Our patient is a 64-year-old white man with a previous history of myocarditis from borreliosis who developed sudden-onset confusional state with perseverations and repetition of the same questions during a funeral for his brother-in-law. Upon neurological work-up and after spontaneous resolution of most of the neurological deficits, transient global amnesia was diagnosed. Blood tests revealed moderate renal insufficiency, elevated troponin-T, and elevated N-terminal prohormone of brain natriuretic peptide. Electrocardiography showed left anterior hemiblock and negative T-waves in V2–V6. Upon transthoracic echocardiography the apical type of a Takotsubo syndrome was suspected. Since coronary angiography was normal and electrocardiography and echocardiographic abnormalities resolved under candesartan, bisoprolol, acetyl-salicylic acid, and atorvastatin within a few days after onset, Takotsubo syndrome was diagnosed.

Conclusions

Since Takotsubo syndrome may be associated with transient global amnesia a causal relation may exist. A possible trigger for both conditions could be severe emotional stress from the loss of a close relative. A possible common pathomechanism could be overstimulation of adrenergic receptors in the myocardium, the cerebrum, or the coronary or cerebral arteries. Whether pre-existing myocardial compromise promotes the development of Takotsubo syndrome requires further investigations.