Transient global amnesia in immediate postoperative period: A diagnostic dilemma

Transient Global Amnesia (TGA) is short-term inability to form new memories despite otherwise normal neurological function. There is associated anterograde and retrograde amnesia. The memory loss is often accompanied by repetitive questioning and temporal disorientation while higher cognitive functions are preserved. The symptoms usually resolve by 24h.

We present an interesting case of 31year old female who was planned for robotically assisted right sided pyeloplasty. 30min after emergence from anaesthesia patient was disoriented, with retrograde and anterograde amnesia, but neurological function was intact. Neurologic imaging revealed no abnormality. 36h later patient was able to recall everything.

The pathogenesis of TGA has more recently been attributed to cerebral venous hypertension resulting from retrograde jugular venous flow. Precipitating events are Valsalva manoeuvre, emotion/stress/pain, Excessive exertion, sexual intercourse and swimming in cold water.

TGA presents dramatically, it needs to be differentiated from cerebral event. It resolves on its own. But one needs to be aware of existence of such an entity.