CTP in Transient Global Amnesia: A Single-Center Experience of 30 Patients

• Published in: American journal of neuroradiology : AJNR 2015-10, Vol.36 (10), p.1830-1833
• Main Authors: Meyer, I A, Wintermark, M, Démonet, J-F, Michel, P
• Format: Article
• Language: English
• Subjects: Adult Brain; Aged; Amnesia, Transient Global - diagnosis; Amnesia, Transient Global - pathology; Cytidine Triphosphate - metabolism; Diffusion Magnetic Resonance Imaging - methods; Dominance, Cerebral - physiology; Female; Hippocampus - pathology; Humans; Image Interpretation, Computer-Assisted; Ischemic Attack, Transient - diagnosis; Ischemic Attack, Transient - pathology; Male; Middle Aged; Stroke - diagnosis; Stroke - pathology; Temporal Lobe - pathology
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A4370

Medial temporal lobe abnormalities on DWI and functional imaging are occasionally observed in patients with transient global amnesia. We used CTP to study these patients during or briefly after resolution of their amnesic syndrome. From 2002 onward, patients satisfying clinical criteria for transient global amnesia who underwent CTP were included. Patients with additional clinical features suggesting transient ischemic attack or stroke and those with an ischemic lesion on subsequent DWI were excluded. If deemed necessary by the clinician, DWI was performed within 10 days. Thirty patients with transient global amnesia underwent CTP at a median latency of 5.9 hours (interquartile range, 4.3-9.7 hours) after symptom onset. All findings, except for those in 1 patient, were normal, including those in the 14 patients with well-imaged hippocampi. In the patient with abnormal findings, CTP and PWI showed hypoperfusion in both lentiform nuclei extending into the insulae, with normalization on the repeat CTP 6 days later. In 10 patients, DWI was performed at a median latency of 2 days (interquartile range, 0-9 days). Of these, 2 showed punctate hippocampal lesions, often seen in transient global amnesia. In 2 patients excluded because of mildly atypical transient global amnesia and ischemic lesions on subsequent DWI, acute CTP findings were also normal. Patients with transient global amnesia had normal CTP findings in the acute phase with the exception of 1 patient with transient hypoperfusion in both basal ganglia. If imaging is performed for typical and atypical transient global amnesia, DWI should be the preferred method.