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Magnetic Resonance Imaging in Transient Global Amnesia

Lessons Learned from 198 Cases

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Abstract

Purpose

Patients with transient global amnesia (TGA) present with a characteristic clinical syndrome although other differential diagnoses have to be considered. Diffusion-weighted imaging (DWI) represents a highly specific diagnostic tool in the context of TGA; however, standard clinical DWI often fails to detect the small characteristic hippocampal lesions. The diagnostic success of DWI sequences in TGA patients was analyzed with respect to slice thickness and time interval between symptom onset.

Methods

Magnetic resonance imaging (MRI) studies of 198 patients with clinically diagnosed TGA were retrospectively analyzed. All DWI studies were grouped according to the slice thickness applied (3 mm, 5 mm and 6 mm). The three groups were assessed for group-specific detection rates of hippocampal lesions with diffusion restriction. In addition the detection rates were evaluated with respect to the time interval between TGA symptom onset and MRI examination.

Results

A significant increase in detection rates (about 8.4% per mm) was found when thinner slices were acquired (44.7% for 3 mm, 27.1% for 5 mm and 19.6% for 6 mm slice thickness). The detection rate was highest (up to 80%) when MRI was performed 2 days after TGA symptom onset.

Conclusions

The MRI protocol in patients with TGA should include a DWI sequence with a slice thickness of 3 mm or less. The examination should be performed on day 2 after symptom onset to fully exploit the diagnostic value of DWI which represents a sensitive and specific diagnostic tool for patients with TGA.

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Conflict of Interest

No potential conflict of interest relevant to this article is reported.

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Authors and Affiliations

  1. Department of Neuroradiology, Charite-Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany

    M. Scheel MD, C. Malkowsky, R. Klingebiel & G. Bohner MD

  2. Department of Neurology, Charite-Universitätsmedizin Berlin, Berlin, Germany

    S. J. Schreiber

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  1. M. Scheel MD
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  2. C. Malkowsky
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  3. R. Klingebiel
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  4. S. J. Schreiber
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  5. G. Bohner MD
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Correspondence to M. Scheel MD.

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Scheel, M., Malkowsky, C., Klingebiel, R. et al. Magnetic Resonance Imaging in Transient Global Amnesia. Clin Neuroradiol 22, 335–340 (2012). https://doi.org/10.1007/s00062-012-0140-7

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  • DOI: https://doi.org/10.1007/s00062-012-0140-7

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