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Amnesia is a condition marked by long-term memory loss, which impairs the ability to recall past events or create new memories.
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Ischemic Amnesia: Causes and Outcome.

Patrik Michel1, Valérie Beaud2, Ashraf Eskandari2

  • 1From the Stroke Center, Neurology Service (P. Michel, A.E., E.E.), Neuropsychology and Neurorehabilitation Service (V.B.), Department of Diagnostic and Interventional Radiology (P. Maeder), and Leenaards Memory Centre (J.-F.D.), Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland. patrik.michel@chuv.ch.

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Summary
This summary is machine-generated.

Amnesia as a primary symptom of acute ischemic stroke is rare but can be mistaken for transient global amnesia (TGA). Early diffusion-weighted imaging is crucial for accurate diagnosis of ischemic amnesia.

Keywords:
amnesiacognitive impairmentcognitive neurologyneuropsychologyneuroradiologystroke

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Area of Science:

  • Neurology
  • Neuroscience
  • Radiology

Background:

  • Acute ischemic stroke and transient ischemic attacks can rarely present with amnesia as the predominant symptom, termed ischemic amnesia.
  • Differentiating ischemic amnesia from transient global amnesia (TGA) is clinically challenging.
  • Amnesia as a primary symptom of cerebral ischemia is uncommon.

Purpose of the Study:

  • To determine the frequency and characteristics of ischemic amnesia.
  • To identify clinical indicators that distinguish ischemic amnesia from TGA.
  • To assess the diagnostic value of diffusion-weighted imaging in acute amnesia.

Main Methods:

  • Retrospective analysis of patients with diffusion-weighted imaging-confirmed ischemic stroke/transient ischemic attacks presenting with amnesia.
  • Comparison of clinical features and stroke mechanisms with a large ischemic stroke registry.
  • Evaluation of diagnostic confusion with transient global amnesia (TGA).

Main Results:

  • Thirteen cases of ischemic amnesia were identified (0.2% of ischemic events).
  • Amnesia was transient in 69% of cases, with a median duration of 5 hours.
  • Ischemic amnesia was often difficult to distinguish from TGA (54%), with 1.2% of presumed TGA cases reclassified.
  • Amnesic strokes frequently involved cardioembolic sources, multiple brain territories, posterior circulation, and the limbic system.
  • Clinical clues included minor focal neurological signs, older age, and stroke risk factors.
  • Despite initial independence, 31% experienced persistent memory issues.

Conclusions:

  • Ischemic amnesia is a rare, often transient neurological event that mimics TGA.
  • Clinical differentiation from TGA can be difficult, highlighting the need for advanced neuroimaging.
  • A low threshold for diffusion-weighted imaging is recommended in cases of acute amnesia to rule out ischemic events.