Reversible Cerebral Vasoconstriction Syndrome Presenting with Transient Global Amnesia

Area of Science:

• Neurology
• Vascular Neurology

Background:

• Transient global amnesia (TGA) is a distinct neurological condition characterized by sudden, temporary memory loss.
• Recurrence of TGA is uncommon, and its association with other cerebrovascular conditions requires further elucidation.

Observation:

• A 65-year-old male with a history of TGA presented with recurrent amnesia and headache.
• Initial workup, including MRI and EEG, was normal, leading to a diagnosis of recurrent TGA.
• The patient later returned with right leg weakness and thunderclap headache, revealing subarachnoid hemorrhage and multifocal segmental narrowing of cerebral arteries on MRI.

Findings:

• The patient was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS).
• The MRI findings demonstrated subarachnoid hemorrhage and multifocal segmental narrowing of the left posterior cerebral artery (PCA) and other large intracranial arteries.
• The patient recovered fully without neurological deficits.

Implications:

• This case suggests that TGA might be a presenting symptom or a prodromal sign of RCVS.
• Clinicians should consider RCVS in the differential diagnosis for patients presenting with TGA, especially with recurrent episodes or associated vascular findings.
• Further research is warranted to explore the relationship between TGA and RCVS to improve diagnostic and therapeutic strategies.