When is the Ideal Time to Perform Brain MRI in Patients with Transient Global Amnesia? Analysis of Case Series with Transient Global Amnesia from Previous Studies, based on Imaging Findings of Diffusion MRI According to Time Criteria

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.

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

BMC Neurology ◽

10.1186/s12883-021-02295-5 ◽

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.

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Transient global amnesia: clinical features and prognostic factors suggesting recurrence

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20180157 ◽

2019 ◽

Vol 77 (1) ◽

pp. 3-9 ◽

Cited By ~ 10

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.

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Diffusion MRI in Pure Transient Global Amnesia Associated with Bilateral Vertebral Artery Dissection

Cerebrovascular Diseases ◽

10.1159/000076964 ◽

2003 ◽

Vol 17 (2-3) ◽

pp. 264-266 ◽

Cited By ~ 8

Author(s):

D. Michel ◽

P. Garnier ◽

F. Schneider ◽

A. Poujois ◽

F.G. BarraI ◽

...

Keyword(s):

Vertebral Artery ◽

Diffusion Mri ◽

Vertebral Artery Dissection ◽

Transient Global Amnesia ◽

Artery Dissection ◽

Global Amnesia

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

Scientific Reports ◽

10.1038/s41598-021-95343-6 ◽

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.

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Concussion Causing Transient Global Amnesia: Further Insights Into Pathophysiology?

Neurology ◽

10.1212/01.wnl.0000720020.86134.9d ◽

2020 ◽

Vol 95 (20 Supplement 1) ◽

pp. S16.1-S16

Author(s):

Basit Shah ◽

Mohammed Wasif Hussain

Keyword(s):

Vasogenic Edema ◽

Case Reports ◽

Transient Global Amnesia ◽

Anterograde Amnesia ◽

Imaging Findings ◽

Rare Presentation ◽

Neurologic Deficits ◽

Ct Head ◽

Global Amnesia

ObjectiveTo review a rare presentation of Transient Global Amnesia (TGA) in context of concussion with reversible imaging findings.BackgroundTGA is characterized by sudden temporary loss of anterograde memory accompanied by repetitive questioning without focal neurologic deficits. While risk factors of age above 50 and migraines remain constant, a clear cause is unknown. The association between TGA and concussion is not well defined beyond 2 case reports in the literature. We review the existing literature and examine a case of TGA in temporal relationship to mild traumatic brain injury (mTBI) or concussion.Design/MethodsCase Report.ResultsA healthy 38-year-old male with no prior concussions or headaches, sustained a concussion after falling backward on pavement. He presented to the emergency room with retrograde amnesia of events 1 hour prior to his injury with subsequent anterograde amnesia. His exam demonstrated normal language and speech and no other focal neurologic deficits. He was diagnosed with TGA with symptoms lasting for 16 hours before fully resolving. Approximately 24 hours after his injury, he developed a migraine headache and tinnitus that was worse with exertion, lasting for roughly 12 hours. His initial CT head while symptomatic demonstrated an area of hypodensity within the left anterior temporal lobe. 2 days after his presentation, he had an MRI with DWI/SWI as well as an EEG, all of which were completely normal, with complete resolution of the finding on CT. He had no further symptoms after his headache resolved and no recurrence of TGA after 12 months follow-up.ConclusionsTGA presenting after a concussion has rarely been reported. We report such a case with imaging findings present during the acute phase that were not present on subsequent MRI suggesting possible reversible vasogenic edema. This may provide insights into the pathophysiology of TGA in this population.

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