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Diffusion-weighted imaging in transient global amnesia exposes the CA1 region of the hippocampus

Neuroradiology volume 49, pages 481–487 (2007)Cite this article

Abstract

Introduction

Transient global amnesia (TGA) is characterized by a sudden onset of anterograde amnesia without alteration of consciousness or personal identity. Interestingly, recent studies have reported a high frequency of small high-signal abnormalities in the hippocampus with diffusion-weighted (DW) imaging, and ischemia has been proposed as an etiology of TGA. We hypothesized that TGA lesions occur preferentially in the CA1 region of the hippocampus, known to be susceptible to ischemia.

Methods

Over a 30-month period 34 patients with TGA underwent MRI including DW imaging within 4 days of symptom onset. Patients with high-signal abnormalities in the hippocampus on the initial DW images underwent subsequent DW and T2-weighted imaging in the coronal plane to identify the precise lesion locations.

Results

Fourteen patients had small (1–3 mm) high-signal abnormalities in the hippocampus unilaterally on DW images. One of these patients had two lesions in one hippocampus and therefore in total 15 lesions were identified: four in the hippocampal head, and 11 in the body. Eleven lesions in ten patients with available coronal images were clearly demonstrated on both coronal DW and T2-weighted images and were localized to the lateral portion of the hippocampus, corresponding to the CA1 region.

Conclusion

Lesions associated with TGA were localized exclusively to the lateral portion of the hippocampus corresponding to the CA1 region. This finding supports the ischemic etiology of TGA; however, the pathophysiological mechanism involved requires further study.

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Acknowledgement

This study was supported by the New Technology Seoul R&BD Program, Republic of Korea (project number 10675).

Conflict of interest statement

We declare that we have no conflict of interest.

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Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, South Korea

    Ho Yun Lee, Jae Hyoung Kim, Young-Cheol Weon, Sung Won Youn & Sung Hyun Kim

  2. Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, 463-707, South Korea

    Jung Seok Lee & Sang Yun Kim

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  1. Ho Yun Lee
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Correspondence to Jae Hyoung Kim.

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Lee, H.Y., Kim, J.H., Weon, YC. et al. Diffusion-weighted imaging in transient global amnesia exposes the CA1 region of the hippocampus. Neuroradiology 49, 481–487 (2007). https://doi.org/10.1007/s00234-007-0213-5

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  • DOI: https://doi.org/10.1007/s00234-007-0213-5

Keywords

  • Magnetic resonance
  • Diffusion MR
  • Transient global amnesia