胃镜检查后出现短暂性全面遗忘症1例

正短暂性全面遗忘症(transient global amnesia,TGA)是一种以一过性记忆丧失为主要特征的临床综合征,目前认为是短暂性脑缺血发作(transient ischemic attacks,TIA)的特殊类型[1],临床上较为少见,而胃镜检查后出现TGA病例在我国尚未见到报道。1临床资料患者女,72岁,因持续上腹疼痛1天入院。入院查体患者神志清楚,中上腹部轻度压痛。化验血常     

伴偏头痛的短暂性全面遗忘症1例

伴偏头痛的短暂性全面遗忘症(transient global amnesia,TGA)的病例报告国内少见,张素玲等2003年总结38例TGA中,仅4例有偏头痛史,现将笔者所遇的1例报告如下.     

短暂性全面遗忘症3例局部脑血流显像观察2年随访

目的 探讨短暂性全面遗忘症(TGA)的发生与局部脑血流(rCBF)改变的关系。方法 对3例临床诊断为TGA患行单光子发射计算机体层摄影(SPECT)rCBF显像检查。结果 2例患SPECT显像示左海马区血流灌注减低，l例示双侧额叶血流灌注减少。3例患随访24个月，均无再次遗忘发作，复查SPECT显像示血流灌注正常。结论 TGA的发生可能与额叶及海马局部血流灌注减低有关。     

短暂性全面遗忘症的临床与PET成像研究

目的:研究短暂性全面遗忘症(transient global amnesia.TGA)患者脑代谢状况,并探讨其发病机理,方法:对3例临床下诊断为TGA的患者,分别行简易心理测试(MMSE)及脑核磁共振成像(MRI),在恢复后不同时间以18F标记的脱氧葡萄糖(18F-FDG)为示踪剂行脑正电子发射型计算机断层扫描(positron emission tomography,PET)成像,并对其图像与 病史进行对照研究.结果:3例患者MMSE测试及MRI扫描均未见异常,PET成像显著,1例正常,另外2例发现与记忆相关相关结构有不同程度的低代谢.结论:TGA的发病机制离缺血的病理生理过程,其脑代谢状况与症状持续时间密切相关,尽早终止其发作是必要的.     

短暂性脑缺血经颅多普勒与脑电图检查对比分析

对 8 8例临床确诊为短暂性脑缺血 (ＴＩＡ)患者同时作经颅多普勒 (ＴＣＤ )和脑电图 (ＥＥＧ)检查 ,以比较两者在ＴＩＡ诊断中的作用。资料与方法1 1 一般资料88例系门诊或住院病人 ,经临床和各项检查确诊为ＴＩＡ ,男 2 1例 ,女 67例 ;年龄 3 1～ 62岁 ,平均 46岁。1 2 检查方法1 2 1 ＴＣＤ检查　采用德国ＥＭＥ公司生产的ＴＣ 2 0 0 0型诊断仪。用 2ＭＨｚ脉冲探头测颅内血管。根据血流频谱、宽度、峰形、峰时、收缩期、舒张期流速、动脉指数及多普勒声频性质等作评估。1 2 2 ＥＥＧ检查　采用日本ＭＥＣ 10 0 0型脑电图机 ,按国际 1…     

短暂性全面遗忘症4例

例1,男,55岁,于2000年3月8日谈话时突然忘记谈话内容,答非所问,反复询问:"怎么回事?"2小时后恢复正常.既往体健.查体:血压113/75 mm Hg(1 mm Hg=0.133 kPa),神志清,对发病前后事情记忆得准确,惟对发病2小时所做的事情无记忆,无神经系统定位体征.脑电图(EEG):超声心动图(ECG)均为正常.头颅磁共振(MRI)多发性腔隙性脑梗死.经颅多普勒超声(TCD):椎-基底动脉供血不足.诊断:短暂性全面遗忘症(TGA).予扩血管及改善脑细胞代谢治疗,半年后随访无复发.例2,女,64岁,于2001年6月3日打麻将牌时,突然坐立不安,说话不对题,不认识周围人物,反复重复:"这是哪里?"3小时后恢复正常.既往患有糖尿病.查体:血压105/83 mm Hg,近记忆下降,无神经系统定位体征.EEG广泛轻度异常,ECG正常,头颅CT示多发性腔隙性脑梗死.TCD示椎-基底动脉紧张度增高.诊断:TGA.予扩血管,改善脑代谢治疗,半年来无复发.     

短暂性全面遗忘综合征2例报道

短暂性全面遗忘(transient global amnesia,TGA)是易发生于中老年人的一种急性遗忘综合征,表现为患者短期内突然不能接受新的信息而保留远期记忆,症状常在24 h内缓解.1956年Bender首次报道,称为伴有遗忘的精神错乱;1958年由Fisher和Adam正式命名为TGA.其后国外有很多这样的病例报道[1-2].据报道,美国的发病率为5.2/105,50岁以上人群发病率为23.5/105.现将我科2007年收治的2例病例报道如下.     

Transient global amnesia occurring as migraine aura

We describe a case of transient global amnesia (TGA) occurring as migraine aura. TGA prevalence is higher among migraineurs and has been ascribed to spreading depression in the hippocampus. Our patient, a 38-year-old physician, developed migraine without aura in early adolescence and from age 20 years, had experienced rare attacks of migraine with aura,. At ages 36 and 38 years, he suffered two attacks of sudden-onset anterograde amnesia, which lasted 5 hours and were immediately followed by unilateral right-sided pounding headaches. Ictal neurological examination was normal except for fixation amnesia. Interictal brain magnetic resonance imaging (MRI) and neurological examination were normal. Thus, in our patient affected with migraine with and without aura, TGA occurred as the aura phase of two migraine attacks. Our case report suggests that TGA shares common mechanisms with migraine. Received: 22 December 1999 / Accepted in revised form: 16 February 2000     

A case of transient global amnesia with hippocampal infarction due to infective endocarditis

Transient global amnesia (TGA) is an uncommon disease characterized by sudden onset anterograde amnesia that typically improves within 24 hours. A 35-year-old woman presented with complete disruption of memory that had started on the previous day. She had fever and heart murmur and was diagnosed as having infective endocarditis with Staphylococcus lugdunensis, a coagulase-negative staphylococcus. Septic embolizations were found in the spleen and kidney on CT scan. The patient underwent aortic valve replacement. MRI susceptibility-weighted imaging showed a dotted low intensity area in the right hippocampus. Recently, etiology of TGA is reported to be related to hippocampal disorder. We report a rare case of TGA with hippocampal infarction due to septic embolism from infective endocarditis.     

短暂性癫痫性遗忘的临床研究

目的探讨短暂性癫痫性遗忘(TEA)的临床特点、诊断及治疗。方法分析5例短暂性癫痫性遗忘患者的临床特征、脑电图、神经影像以及治疗情况。结果患者符合TEA诊断标准,脑电图及影像学检查无明显异常发现,经抗癫痫药治疗后症状控制。结论 TEA是一种罕见的、表现较为独特的癫痫发作形式,以发作期的遗忘性发作和发作间期的记忆损伤为主要特点,多见于中老年人。TEA是一种可控性疾病,抗癫痫药物治疗能够使发作期遗忘和发作间期的记忆障碍得到有效缓解,早期诊断有重要意义。     

The link between reversible cerebral vasoconstriction syndrome and transient global amnesia

Reversible cerebral vasoconstriction syndrome (RCVS) and transient global amnesia (TGA) are acute and self-limiting intra-cerebral conditions. Although previously studied as independent phenomena, there are increasing reports of co-occurrence of these two pathologies. We report a 55-year-old male who presented to the hospital with recurrent thunderclap headaches over the course of 1 week with sudden onset of anterograde memory loss. His medications included a selective serotonin reuptake inhibitor and intermittent use of pseudoephedrine. On examination he was amnestic to recent events and notably perseverating. Magnetic resonance imaging of the brain without contrast showed a small, punctate focus of restricted diffusion in the left hippocampus. He was diagnosed with TGA based on his clinical presentation. His headaches and amnesia resolved over the next 12 h throughout the course of his stay with acetaminophen and oral verapamil and he was discharged. Repeat computed tomography angiogram at 2 weeks revealed diffuse and segmental narrowing of the anterior and posterior intracranial circulation, which resolved on follow-up imaging at 3 months, confirming RCVS. The acute and reversible nature of these conditions and increasing reports of co-occurrence suggests a common pathophysiologic link. We review the literature highlighting similar cases and the presumed pathophysiology.     

Transient global amnesia triggered by migraine in monozygotic twins

Transitory global amnesia and migraine without aura are diseases with unclear pathophysiologic mechanisms, but with evidence of comorbidity. We describe twin monozygotic brothers, both presenting episodes of transitory global amnesia occurring only during attacks of migraine without aura. This report supports the hypothesis of a common underlying pathogenetic mechanism, possibly related to the cortical spreading depression. Furthermore, a common genetic trait in both the diseases or more probably in a particular subgroup of patients could be hypothesized.     

Transient global amnesia: cerebral venous outflow impairment-insight from the abnormal flow patterns of the internal jugular vein

Cerebral venous reflux is found frequently in transient global amnesia (TGA) patients. The cerebral venous reflux mostly results from left brachiocephalic venous obstruction, and the level of reflux depends on different respiratory status. For further understanding of the role of venous outflow impairment in the pathogenesis of TGA, we used color duplex sonography to reveal the flow patterns in the internal jugular vein (IJV) and its branches (JB) under different respiratory conditions. We compared the frequency of abnormal venous flow of IJV and/or JB on color duplex sonography between 17 TGA patients and 17 age- and gender-matched normal individuals both at rest (regular breathing) and at deep inspiration. Further, these venous-flow abnormalities in IJV and JB were well described. Cranial 3-D time-of-flight magnetic resonance arteriography (MRA) were performed in all patients three to seven days after their TGA attacks and in all normal individuals to analyze the abnormal flow signals in the intracranial venous structures. In the result, abnormal flow-patterns in the left IJV and/or left JB during regular breathing were found more frequently in TGA patients than normal individuals (65% vs. 6%; p < 0.001). These abnormalities in TGA patients were (1) isolated reversed flow in the left JB, (2) segmental reversed flow in the left distal IJV and (3) continuous reversed flow in the left IJV and JB. The MRA study revealed that only the most severe reflux in the IJV causes intracranial venous reflux; six were in the group of continuous reversed flow in left IJV and one was in the group of segmental reversed flow in left distal IJV. These findings suggest that TGA might be one of the clinical manifestations of the "cerebral-type intermittent venous claudication," which stems from cerebral venous outflow impairment, insufficient venous collaterals and specific precipitating factors.     

短暂性全面遗忘症3例局部脑血流显像观察2年随访

目的探讨短暂性全面遗忘症(TGA)的发生与局部脑血流(rCBF)改变的关系。方法对3例临床诊断为TGA患者行单光子发射计算机体层摄影(SPECT)rCBF显像检查。结果2例患者SPECT显像示左海马区血流灌注减低,1例示双侧额叶血流灌注减少。3例患者随访24个月,均无再次遗忘发作,复查SPECT显像示血流灌注正常。结论TGA的发生可能与额叶及海马局部血流灌注减低有关。     

Transient global amnesia, migraine, thalamic infarct, dihydroergotamine, and sumatriptan

This case report describes an episode of transient global amnesia that occurred during a migraine attack, which had been treated with vasoconstrictors. Magnetic resonance imaging showed a small lesion with an ischemic appearance in the right thalamus.     

"Forgettable" sex: a case of transient global amnesia presenting to the emergency department

Background: Transient global amnesia is characterized by the sudden development of dense anterograde amnesia, without alteration in level of consciousness and in the absence of focal neurologic deficits or seizure activity. Various precipitating causes have been reported in the medical literature. Objective: To present a literature-guided approach to the diagnosis and management of transient global amnesia in the Emergency Department (ED). Case Report: We report the case of a 54-year-old woman who presented to the ED with an episode of acute memory loss. Conclusions: Although rare, transient global amnesia may present in a dramatic fashion. The occurrence of a distinct precipitating event and repetitive questioning seem to be key features in making the diagnosis. Important differential considerations include transient ischemic attack, seizure, and subarachnoid hemorrhage. Brain imaging and specialty consultation are reserved primarily for patients with unclear circumstances, altered level of consciousness, focal neurologic findings, and persistent (or very brief) amnestic symptoms. Brain imaging may, however, relieve anxiety about more dangerous causes of the event.     

短暂性全面遗忘症的随访分析

目的:探讨短暂性全面遗忘症(transientglobalamnesia,TGA)和脑卒中的发病关系。方法:选择1994-10/2004-10安阳市人民医院和安阳市第二人民医院神经内科住院及门诊有详细记录且已得到随访的TGA患者16例为观察组。选择同期在两所医院就诊的高血压、糖尿病、冠心病患者16例作为对照组。嘱两组患者2～6个月复诊一次作为随访,比较两组患者随访期间脑卒中发生率。结果:观察组患者患TGA后1～10年的患者出现脑卒中的发生率犤44%(7/16)犦明显高于对照组犤12%(2/16)犦,两组比较,差异有显著性意义(χ2=3.865,P<0.05)。结论:TGA和脑缺血有关,应将TGA患者作为脑卒中二级预防的对象。