Bilateral fornix infarction presented with acute amnesia: case report
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Updated: Oct 6, 2025
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Hui Zhang1, Ya Zhang2, Xin Jiang3
1Department of Neurology, Hebei Medical University, Shijiazhuang, China.
Abstract:
Acute episodes of amnestic syndrome can be a challenging diagnostic problem. Except for nonvascular etiology, thalamic strokes or infarction involving several temporal lobe structures has been reported in earlier cases. The authors report a patient who suddenly developed memory loss without any other focal neurologic deficits. Brain magnetic resonance imaging (MRI) with diffusion-weighted imaging (DWI) performed 1 day after onset revealed acute infarction involving the bilateral fornix column and the genu of corpus callosum. Because simple fornix infarcts often have no obvious positive neurological signs, most of the related manifestations were provided by family members, are easy to be diagnosed falsely, and missed in clinical areas, we suggest that bilateral fornix infarction should be considered in the diagnosis of an acute onset amnestic syndrome.
Insights
Acute memory loss can be difficult to diagnose. Bilateral fornix infarction, a stroke affecting brain memory pathways, should be considered in patients with sudden onset amnestic syndrome.
Area of Science:
- Neurology
- Neuroimaging
- Neuroscience
Background:
- Acute amnestic syndrome presents diagnostic challenges.
- Previous cases of memory loss involved thalamic strokes or temporal lobe structures.
- Nonvascular etiologies are also considered in memory loss.
Observation:
- A patient presented with sudden memory loss and no other focal neurological deficits.
- Brain MRI with diffusion-weighted imaging (DWI) was performed one day after symptom onset.
- The MRI revealed acute infarction in the bilateral fornix column and genu of the corpus callosum.
Findings:
- Infarction of the bilateral fornix column and genu of the corpus callosum was identified.
- Simple fornix infarcts often lack obvious positive neurological signs.
- Clinical manifestations are frequently reported by family members, leading to potential misdiagnosis.
Implications:
- Bilateral fornix infarction can be easily missed in clinical settings.
- This condition should be included in the differential diagnosis for acute amnestic syndrome.
- Neuroimaging, particularly DWI-MRI, is crucial for identifying these specific infarcts.
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