scholarly journals Transient Global Amnesia (TGA): Younger Age and Absence of Cerebral Microangiopathy Are Potentially Predisposing Factors for TGA Recurrence

2021 ◽  
Vol 12 ◽  
Author(s):  
Andreas Rogalewski ◽  
Anne Beyer ◽  
Anja Friedrich ◽  
Jorge Plümer ◽  
Frédéric Zuhorn ◽  
...  
Keyword(s):  
Transient Global Amnesia ◽  
Recurrence Risk ◽  
First Episode ◽  
Chronic Hypertension ◽  
Younger Age ◽  
Cerebral Microangiopathy ◽  
Global Amnesia ◽  
Magnetic Resonance Imaging Mri ◽  
Unclear Etiology

Background: Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear etiology for a period of less than 24 h. TGA occurs as a single event in most cases. Prevalence rates of recurrent TGA vary widely from 5.4 to 27.1%. This retrospective study aimed to determine predictors for TGA recurrence.Methods: Cardiovascular risk profile and magnetic resonance imaging (MRI) of 340 hospitalized TGA patients between 2011 and 2020 were retrospectively analyzed. The median follow-up period amounted to 4.5 ± 2.7 years. Comparisons were made between TGA patients with and without subsequent recurrence.Results: TGA patients with subsequent recurrence were significantly younger (recurrent vs. single episode, 63.6 ± 8.6 years vs. 67.3 ± 10.5 years, p = 0.032) and showed a lower degree of cerebral microangiopathy compared to TGA patients without recurrence. The mean latency to recurrence was 3.0 years ± 2.1 years after the first episode. In a subgroup analysis, patients with at least five years of follow-up (N = 160, median follow-up period 7.0 ± 1.4 years) had a recurrence rate of 11.3%. A 24.5% risk of subsequent TGA recurrence in the following five years was determined for TGA patients up to 70 years of age without microangiopathic changes on MRI (Fazekas' score 0).Conclusion: Younger TGA patients without significant microangiopathy do have an increased recurrence risk. In turn, pre-existing cerebrovascular pathology, in the form of chronic hypertension and cerebral microangiopathy, seems to counteract TGA recurrence.

scholarly journals Recovery from Transient Global Amnesia Following Restoration of Hippocampal and Fronto–Cingulate Perfusion

2010 ◽  
Vol 22 (3-4) ◽  
pp. 131-139 ◽  
Author(s):  
Paolo Caffarra ◽  
Letizia Concari ◽  
Simona Gardini ◽  
Sabrina Spaggiari ◽  
Francesca Dieci ◽  
...  
Keyword(s):  
Acute Phase ◽  
Neuropsychological Testing ◽  
Transient Global Amnesia ◽  
Normal Limits ◽  
Global Amnesia ◽  
One Year ◽  
The Right ◽  
Rcbf Spect ◽  
Subject Comparison

A patient who suffered a transient global amnesia (TGA) attack underwent regional cerebral blood flow (rCBF) SPECT imaging and neuropsychological testing in the acute phase, after one month and after one year. Neuropsychological testing in the acute phase showed a pattern of anterograde and retrograde amnesia, whereas memory was within age normal limits at follow up. SPECT data were analysed with a within subject comparison and also compared with those of a group of healthy controls. Within subject comparison between the one month follow up and the acute phase detected increases in rCBF in the hippocampus bilaterally; further rCBF increases in the right hippocampus were detected after one year. Compared to controls, significant hypoperfusion was found in the right precentral, cingulate and medial frontal gyri in the acute phase; after one month significant hypoperfusion was detected in the right precentral and cingulate gyri and the left postcentral gyrus; after one year no significant hypoperfusion appeared. The restoration of memory was paralleled by rCBF increases in the hippocampus and fronto-limbic-parietal cortex; after one year neither significant rCBF differences nor cognitive deficits were detectable. In conclusion, these data indicate that TGA had no long lasting cognitive and neural alterations in this patient.

P 144 Longer-term spatial navigation deficits in transient global amnesia – a follow-up study

2017 ◽  
Vol 128 (10) ◽  
pp. e398-e399
Author(s):  
A. Zwergal ◽  
S. Irving ◽  
C. Trapp ◽  
C. Pradhan ◽  
M. Dieterich ◽  
...  
Keyword(s):  
Spatial Navigation ◽  
Transient Global Amnesia ◽  
Follow Up Study ◽  
Global Amnesia

Transient global amnesia and transient ischaemic attacks: controversy concerning the neuropsychological assessment in the follow-up

1987 ◽  
Vol 235 (2) ◽  
pp. 125-126 ◽  
Author(s):  
J. Matias-Guiu ◽  
I. Bonaventura ◽  
P. Casquero ◽  
E. Calatayud ◽  
A. Codina ◽  
...  
Keyword(s):  
Neuropsychological Assessment ◽  
Transient Global Amnesia ◽  
Transient Ischaemic Attacks ◽  
Global Amnesia

scholarly journals Fate of contralateral asymptomatic bullae in patients with primary spontaneous pneumothorax

2020 ◽  
Vol 58 (2) ◽  
pp. 365-370
Author(s):  
Hyo Jun Jang ◽  
Jun Ho Lee ◽  
Seung Hyuk Nam ◽  
Sun Kyun Ro
Keyword(s):  
Spontaneous Pneumothorax ◽  
Multivariable Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
First Episode ◽  
High Resolution Computed Tomography ◽  
Contralateral Lung ◽  
Younger Age ◽  
Independent Risk Factors ◽  
The Impact

Abstract OBJECTIVES This retrospective cohort study aimed to analyse the impact of asymptomatic blebs/bullae on the occurrence of primary spontaneous pneumothorax (PSP) by monitoring the natural course of contralateral blebs/bullae in patients with ipsilateral pneumothorax. METHODS From January 2003 to December 2017, 1055 patients [age 19.6 ± 3.98 years (mean ± standard deviation), 953 men] experiencing the first episode of unilateral PSP were enrolled in this study, excluding patients aged 30 years or more. The presence, number and maximal size of the blebs/bullae were investigated in contralateral asymptomatic lungs based on high-resolution computed tomography. RESULTS Multiple and single blebs/bullae were noted in contralateral lungs in 425 (40.3%) and 88 (8.3%) patients, respectively. The median follow-up period was 44.0 (interquartile range 71.5) months. The 1-, 3- and 5-year cumulative occurrence rates of PSP in contralateral lungs were 7.9%, 13.7% and 16.7%, respectively. On multivariable analysis, younger age [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.12–1.27; P < 0.001) and multiple bullae (HR 4.42, 95% CI 3.06–6.38; P < 0.001) were independent risk factors for spontaneous pneumothorax in the contralateral lung. The 5-year cumulative occurrence rates of PSP were significantly higher in patients with multiple blebs/bullae than in those with no or a single bleb/bulla (28.2% vs 8.5%, respectively; P < 0.001). CONCLUSIONS Asymptomatic blebs/bullae often lead to PSP. If the patient is eligible for surgery for pneumothorax, preemptive surgery for contralateral bullae could be considered, especially in patients with multiple blebs/bullae.

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.

Comorbidities, alone and in combination with D-dimer, as risk factors for recurrence after a first episode of unprovoked venous thromboembolism in the extended follow-up of the PROLONG study

2010 ◽  
Vol 103 (06) ◽  
pp. 1152-1160 ◽  
Author(s):  
Cristina Legnani ◽  
Alberto Tosetto ◽  
Vittorio Pengo ◽  
Angelo Ghirarduzzi ◽  
Sophie Testa ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Patient Characteristics ◽  
Recurrence Risk ◽  
Randomised Clinical Trial ◽  
Chronic Inflammatory Bowel Disease ◽  
First Episode ◽  
Chronic Obstructive ◽  
Risk Of Recurrence ◽  
D Dimer

SummaryThe PROLONG randomised clinical trial showed that an abnormal D-dimer at one month after vitamin K antagonist (VKA) suspension for a first episode of unprovoked venous thromboembolism (VTE) is associated with a higher risk of recurrence. However, other patient characteristics, such as comorbidities, in combination with D-dimer could also influence the recurrence risk. It was the objective of this study to assess the predictive value of comorbidities and D-dimer in combination for recurrence after withdrawal of VKA in patients enrolled in the PROLONG study. On the day of VKA suspension, the presence of known (coronary, peripheral,cerebral) vascular disease, chronic inflammatory bowel disease, chronic obstructive pulmonary disease, autoimmune disease, diabetes, arterial hypertension, obesity and dyslipidaemias was registered. D-dimer was measured at 30 ± 10 days afterwards. The primary outcome was recurrent objectively documented VTE. Mean follow-up was 2.55 years. An abnormal D-dimer was observed in 44% (135/309) of patients with comorbidities and in 29% (87/299) of patients without (p=0.0003). An on-treatment analysis was conducted in 483 patients in whom VKAs were not resumed. In patients with a normal D-dimer, recurrences were observed in 14.3% (24/168) of patients with comorbidities and 10.8% (22/203) of subjects without (p=ns). In patients with an abnormal D-dimer, recurrences were observed in 24.6% (16/65) patients with comorbidities and 21.3% (10/47) of patients without (p=ns). Although abnormal D-dimer levels were significantly more frequent in patients with comorbidities, D-dimer was an independent risk factor for recurrence and the presence of comorbidities did not increase the risk of recurrence associated with an abnormal post-anticoagulation D-dimer.ClinicalTrials.gov number: NCT00264277

Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study

2005 ◽  
Vol 12 (5) ◽  
pp. 350-356 ◽  
Author(s):  
L. Pantoni ◽  
E. Bertini ◽  
M. Lamassa ◽  
G. Pracucci ◽  
D. Inzitari
Keyword(s):  
Risk Factors ◽  
Clinical Features ◽  
Transient Global Amnesia ◽  
Follow Up Study ◽  
Global Amnesia
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