NCMP-05. LEFT BASAL GANGLIA/INTERNAL CAPSULE GLIOBLASTOMA WITH MEMORY LOSS FROM CONTRALATERAL RADIATION INDUCED VASCULOPATHIES

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi148-vi148
Author(s):  
Shannon Higgins ◽  
Andrew Lassman ◽  
Laura Lennihan ◽  
Joshua Willey ◽  
Tony Wang ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Memory Impairment ◽  
Brain Mri ◽  
Memory Loss ◽  
Internal Capsule ◽  
Transient Global Amnesia ◽  
Vascular Abnormalities ◽  
Brain Radiotherapy ◽  
Radiation Induced ◽  
Global Amnesia

Abstract INTRODUCTION Radiation induced cerebral vasculopathy encompasses a complex and broad range of effects such as ischemia, hemorrhage, vascular malformation, capillary telangiectasias, and large vessel stenosis caused by pathological reorganization of tissue after radiation exposure. Necrosis and inflammation induce damage and demyelinating changes to other vessels over the corresponding areas that may occur months to years after brain irradiation. Here we report an unusual case of hemorrhagic basal ganglia/internal capsule glioblastoma followed by contralateral basal ganglia/internal capsule acute infarct with resulting acute transient global amnesia followed by chronic memory impairment. CASE REPORT A 58-year old man was diagnosed with a hemorrhagic left basal ganglia/internal capsule mass after presenting with severe headaches, agitation, and vomiting. Glioblastoma (IDH wild type by sequencing, MGMT unmethylated) was identified on resection. He underwent radiotherapy and concurrent and adjuvant (12 cycles) temozolomide. Serial surveillance brain MRI scans demonstrated multiple incidental vascular abnormalities including subacute right basal ganglia/internal capsule ischemic infarct, right temporal cavernoma, and right temporal intra-parenchymal hemorrhage approximately 1, 2, and 3 years after diagnosis, respectively. Approximately 4 years after diagnosis, he presented with transient global amnesia and imaging demonstrated right basal ganglia/internal capsule ischemic stroke. DISCUSSION Bilateral basal ganglia/internal capsule damage from stroke has been reported as causing memory impairment (Tatemichi TK et al, Neurology 1992;42:1966-79; PMID 1407580). Here we report memory impairment from unilateral basal ganglia/internal capsule tumor and contralateral infarct following brain radiotherapy as another mechanism of neurocognitive injury. Our case highlights the significance of continuing to surveil for these findings as new neurologic symptoms may mimic tumor progression.

scholarly journals How to forget a “traumatic” experience: a case report of transient global amnesia after nasopharyngeal swab for Coronavirus disease 19

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabrina Ravaglia ◽  
Antonio Zito ◽  
Lara Ahmad ◽  
Isabella Canavero
Keyword(s):  
Short Term Memory ◽  
Brain Mri ◽  
Memory Loss ◽  
Transient Global Amnesia ◽  
Clinical Syndrome ◽  
Traumatic Experience ◽  
Nasopharyngeal Swab ◽  
Medical Procedures ◽  
Diffusion Weight Image ◽  
Global Amnesia

Abstract Background Transient global amnesia (TGA) is a clinical syndrome characterized by a temporary short-term memory loss with inability to retain new memories, usually lasting 2 to 8 h. TGA may be related to several medical procedures, including angiography, general anesthesia, gastroscopy. Case presentation We report a 58-year-old woman who experiencing TGA one hour after the execution of her first-time nasopharyngeal swab for COVID-19. Brain MRI showed a typical punctate Diffusion Weight Image (DWI) hippocampal lesion. Conclusions This is the first report of TGA after the execution of nasopharyngeal swab for COVID-19. This association lengthen the list of medical procedures associated with TGA, and we discuss the possible plausible mechanisms by which a nasopharyngeal swab could trigger TGA.

scholarly journals Transient Global Amnesia Associated with an Acute Infarction at the Cingulate Gyrus

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Alejandro Gallardo-Tur ◽  
Jorge Romero-Godoy ◽  
Carlos de la Cruz Cosme ◽  
Adriá Arboix
Keyword(s):  
Limbic System ◽  
Short Term Memory ◽  
Memory Loss ◽  
Brain Magnetic Resonance Imaging ◽  
Transient Global Amnesia ◽  
Cingulate Gyrus ◽  
Clinical Disorder ◽  
Acute Infarction ◽  
Maximal Diameter ◽  
Global Amnesia

Background. Transient global amnesia (TGA) is a syndrome of sudden, unexplained isolated short-term memory loss. In the majority of TGA cases, no causes can be identified and neuroimaging, CSF studies and EEG are usually normal. We present a patient with TGA associated with a small acute infarct at the cingulate gyrus.Case Report. The patient, a 62 year-old man, developed two episodes of TGA. He had hypertension and hypercholesterolemia. He was found to have an acute ischemic stroke of small size (15 mm of maximal diameter) at the right cerebral cingulate gyrus diagnosed on brain magnetic resonance imaging. No lesions involving other limbic system structures such as thalamus, fornix, corpus callosum, or hippocampal structures were seen. The remainder of the examination was normal.Conclusion. Unilateral ischemic lesions of limbic system structures may result in TGA. We must bear in mind that TGA can be an associated clinical disorder of cingulate gyrus infarct.

scholarly journals Transient Global Amnesia as a Possible First Manifestation of COVID-19

2020 ◽  
Vol 11 (1) ◽  
pp. 84-86
Author(s):  
Haitham M. Hussein
Keyword(s):  
Nervous System ◽  
Respiratory Failure ◽  
Brain Mri ◽  
Transient Global Amnesia ◽  
Respiratory Illness ◽  
X Ray ◽  
Unexplained Fever ◽  
Chest X Ray ◽  
Hypoxic Respiratory Failure ◽  
Global Amnesia

Evidence of involvement of the nervous system in COVID-19 disease is accumulating. We describe a case of a 53-year-old man presented with classic syndrome of transient global amnesia with symptoms lasting less than 24 hours and mild transient unexplained fever. Workup including brain MRI, electroencephalogram, and chest X ray was negative and the patient was discharged. The day after discharge, the patient started to experience the classic respiratory and systemic COVID-19 illness and was eventually readmitted with hypoxic respiratory failure and positive COVID-19 test a week after the first hospital discharge. The case highlights the importance of neurological syndromes as presenting prodrome to the respiratory illness of COVID-19.

scholarly journals Transient global amnesia: clinical features and prognostic factors suggesting recurrence

2019 ◽  
Vol 77 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Lucas Alessandro ◽  
Ismael L. Calandri ◽  
Marcos Fernández Suarez ◽  
María L. Heredia ◽  
Hernán Chaves ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Brain Mri ◽  
Transient Global Amnesia ◽  
Recurrence Risk ◽  
The Other ◽  
Multivariate Logistic Regression Model ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Global Amnesia

ABSTRACT The risk of recurrence of new amnesia events in patients having previously experienced transient global amnesia (TGA) ranges between 2.9-23.8%. Objective: Our objective was to search for recurrence predictors in TGA patients. Methods: Retrospective analysis to identify recurrence predictors in a cohort of 203 TGA patients from a single center in Buenos Aires, Argentina, diagnosed between January 2011 and March 2017 Clinical features and complementary studies (laboratory results, jugular vein Doppler ultrasound and brain MRI) were analyzed. Comparison between patients with recurrent versus single episode TGA was performed, applying a multivariate logistic regression model. Results: Mean age at presentation was 65 years (20-84); 52% were female. Median time elapsed between symptom onset and ER visit was two hours, with the average episode duration lasting four hours. Mean follow-up was 22 months. Sixty-six percent of patients referred to an identifiable trigger. Jugular reflux was present in 66% of patients; and 22% showed images with hippocampus restriction on diffusion-weighted MRI. Eight percent of patients had TGA recurrence. Patients with recurrent TGA had a more frequent history of migraine than patients without recurrence (37.5% vs. 14%; p = 0.03). None of the other clinical characteristics and complementary studies were predictors of increased risk of recurrence. Conclusions: Patients with migraine may have a higher risk of recurrent TGA. None of the other clinical characteristics evaluated allowed us to predict an increased risk of recurrence. Although the complementary studies allowed us to guide the diagnosis, they did not appear to have a significant impact on the prediction of recurrence risk.

scholarly journals Neonatal Brain MRI and Motor Outcome at School Age in Children with Neonatal Encephalopathy: A Review of Personal Experience

2003 ◽  
Vol 10 (1-2) ◽  
pp. 51-57 ◽  
Author(s):  
Eugenio Mercuri ◽  
Anna L. Barnett
Keyword(s):  
White Matter ◽  
Basal Ganglia ◽  
Brain Mri ◽  
White Matter Lesions ◽  
Internal Capsule ◽  
School Age ◽  
Neonatal Encephalopathy ◽  
Neonatal Brain ◽  
Motor Outcome ◽  
Motor Abnormalities

The aim of this paper is to review (i) the spectrum of neuromotor function at school age in children who had been born full-term and presented with neonatal encephalopathy (NE) and low Apgar scores and (ii) the relation between the presence/absence of such difficulties and neonatal brain MRI. Motor outcome appears to be mainly related to the severity of basal ganglia and internal capsule involvement. Severe basal ganglia lesions were always associated with the most severe outcome, microcephaly, tetraplegia, and severe global delay, whereas more discrete basal ganglia lesions were associated with athetoid cerebral palsy, with normal cognitive development or minor neuro-motor abnormalities. White matter lesions were associated with abnormal motor outcome only if the internal capsule was involved. Children with moderate white matter changes but normal internal capsule, had normal motor outcome at school age.

scholarly journals Increased biological antioxidant potential in the cerebrospinal fluid of transient global amnesia patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takayuki Kawai ◽  
Ryuji Sakakibara ◽  
Yosuke Aiba ◽  
Fuyuki Tateno ◽  
Tsuyoshi Ogata ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cerebrospinal Fluid ◽  
Brain Mri ◽  
Antioxidant Properties ◽  
Transient Global Amnesia ◽  
Pathological Process ◽  
Antioxidant Potential ◽  
Control Subjects ◽  
Total Antioxidant ◽  
Global Amnesia

AbstractOxidative stress may accompany the pathological process in transient global amnesia (TGA). We measured the biological antioxidant potential (BAP) in the cerebrospinal fluid (CSF) of TGA patients. We enrolled 13 TGA patients (7 men, 6 women; mean age 65.0 years [48–70 years]) and 24 control subjects (12 men, 12 women; mean age 38.2 years [17–65 years]; age did not correlate with csfBAP in this group). We performed brain MRI in all TGA patients, and CA1 lesions were noted by MRI in 5 subjects. We measured csfBAP, total antioxidant properties, in all TGA patients and controls. csfBAP levels were higher in TGA patients than in controls (p = 0.024, 0.028). csfBAP levels in TGA patients did not differ between MRI-positive and -negative subgroups. Elevated csfBAP levels were observed in TGA patients, suggesting that oxidative stress may have a role in the pathogenesis of TGA.

scholarly journals BMC NeurologyFactors determining recurrence in transient global amnesia

2019 ◽  
Author(s):  
Rebecca Tynas ◽  
Peter K Panegyres
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Head Injury ◽  
Memory Impairment ◽  
Transient Global Amnesia ◽  
Clinical History ◽  
Subjective Memory ◽  
Subjective Memory Impairment ◽  
History Of ◽  
Global Amnesia

Abstract Aetiology of transient global amnesia (TGA) remains uncertain, though many have been proposed, including ischaemic, migrainous or epileptic pathologies. We attempted to determine risk factors for TGA, as well as prognostic factors that may cause recurrence. We evaluated clinical history, family history and magnetic resonance diffusion-weighted imaging (DWI) studies of 93 prospective patients with TGA. Patients were followed from 2004-2016. Fifteen of 93 (16%) patients experienced a recurrence of TGA. Among precipitating events, physical activities inducing Valsalva-like manoeuvres were most common, followed by emotional stress. Eighty-four patients had possible comorbidities or risk factors for TGA, though no single risk factor was ubiquitous. Risk factors associated with recurrence were head injury (isolated vs. recurrent, 16.7% vs. 53.5%, p < 0.01), depression (isolated vs. recurrent, 15.4% vs 46.7%, p = 0.01) and family history of dementia (isolated vs. recurrent, 20.5% vs. 46.7%, p = 0.03). Of 15 patients with confirmed recurrent TGA, two developed dementia and four subjective memory impairment. DWI lesions were observed in 24 patients and were located anywhere within the hippocampus. DWI lesions were not significantly associated with outcomes (recurrence, subjective memory impairment, dementia). We have found that depression, previous head injury and family history of dementia may predict TGA recurrence.

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