11/21/2023 0 Comments Transient global amnesia vs tia![]() ![]() In 11% (14/126), patients had additional acute DWI lesions (with corresponding ADC hypointensity) in brain areas outside the hippocampus. Unilateral hippocampal lesion occurred in 41% (52/126) and bilateral hippocampal lesions in 15% (19/126) of patients. In 56% (71/126) of all patients, one or more acute punctuate DWI lesion were found in hippocampal CA1-areas. Table 1 shows characteristics of all patients with clinical TGA in whom 3 T MRI was performed and compares demographic and clinical characteristics of TGA patients with and without additional ischemic lesions on DWI. In addition to the 126 patients, we identified and excluded 78 patients with clinically diagnosed TGA in whom 3 T MRI was not performed for different reasons (contraindication for MRI, discharge before MRI could be performed). In total, we identified 126 patients with clinically diagnosed TGA and 3 T MRI within 72 h of symptom onset between January 2010 and January 2017, with a mean age of 66 (± 10) years 66 (52%) were female. 1) at other locations outside the hippocampal level. Besides the expected lesions in hippocampal CA1-area, DWI was screened for possible lesions (Fig. The sequence parameters for high-resolution DWI were: slice thickness 2.5 mm, repetition time TR 8900 ms, echo time TE 93 ms, slice gap 0, b values were mm*2/s. The MRI standard stroke protocol included high-resolution DWI, T2*-weighted imaging, MR-angiography and fluid attenuated inversion recovery (FLAIR). In accordance with the Berlin State legislation, no separate ethics committee approval was required for this retrospective analysis.Īll MRI examinations were performed on a 3 T MR scanner (Magnetom Trio Siemens AG, Germany, 32-channel head coil). Patients’ demographic and clinical data obtained included age, sex, time of symptom onset and cardiovascular risk factors. Patients with clinical TGA and additional acute ischemic lesions on DWI were diagnosed as ischemic stroke. Patients with clinical TGA and uni- or bilateral isolated punctuate DWI lesion in the hippocampus were diagnosed as TGA. Cerebral MRI was performed in all patients within 72 h from symptom onset. TGA was defined according to established diagnostic criteria : witnessed attack, anterograde amnesia, no loss of consciousness or personal identity, cognitive impairment limited to amnesia no other focal neurological symptoms during the attack or afterwards no epileptic features or active epilepsy, no recent head injury, and resolution of symptoms within 24 h. Every patient was examined by a neurologist in the emergency department. Therefore, in patients with additional brain infarcts, the suspected diagnosis changed from TGA to final diagnosis stroke. MRI was normally performed the next morning after admission. To reduce selection bias, we screened for TGA as suspected diagnosis in the emergency department and not for TGA as final diagnosis. All patients were identified by searching our hospital digital patient records (SAP Clinical Workstation, SAP, Germany) for in-patients with the diagnosis TGA according to the International Classification of Diseases Tenth Revision. ![]() Therefore, cerebral MRI should be performed in patients with TGA to identify a possible cardiac involvement and to detect stroke chameleons.Ĭonsecutive patients clinically presenting with TGA between January 2010 and January 2017 admitted to our hospital were retrospectively evaluated. In a relevant proportion of clinical TGA patients, MRI reveals acute ischemic cerebral lesions. All patients with DWI lesions outside the hippocampus presented with neurological symptoms typical for TGA (without additional symptoms.) Conclusions Additional acute DWI lesions in other cortical regions were found in 11% ( n = 14/126). Fifty-three percent ( n = 71/126) presented with one or more acute lesions in hippocampal CA1-area. ResultsĪ total of 126 cases were included into the study. We analyzed imaging and clinical data of all patients undergoing MRI with high-resolution diffusion-weighted imaging within 72 h from symptom onset. All patients fulfilled diagnostic criteria of TGA. ![]() MethodsĬonsecutive patients clinically presenting with TGA between January 2010 and January 2017 admitted to our hospital were retrospectively evaluated. To determine the frequency and distribution pattern of acute DWI lesions outside the hippocampus in patients clinically presenting with Transient Global Amnesia (TGA). ![]()
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