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Transient Global Amnesia and High-Grade Styloidogenic Jugular Vein Stenosis
Mohamed S Muneer1, Kellen Vo Vu2, Siddhant S Dhawan3
1Division of Neuroimaging and Neurointervention, Department of Radiology, Stanford University School of Medicine, Stanford, California.
JAMA Network Open
|February 26, 2026
Summary
Transient global amnesia (TGA) is linked to severe styloidogenic jugular vein compression (SJVC), particularly on the right side or bilaterally. This finding suggests that assessing SJVC severity via MRI may aid in diagnosing TGA.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- The exact cause of hippocampal ischemia in transient global amnesia (TGA) is unknown, but venous issues are suspected.
- Current MRI diffusion-weighted imaging has limitations for diagnosing TGA, necessitating better imaging markers.
Purpose of the Study:
- To investigate if styloidogenic jugular vein compression (SJVC) severity, potentially hindering venous drainage, could be a new imaging risk factor for TGA diagnosis.
Main Methods:
- A retrospective case-control study compared patients with TGA and hippocampal diffusion restriction to controls.
- Brain MRI assessed internal jugular vein (IJV) cross-sectional areas and SJVC stenosis percentages.
- Statistical analysis determined the association between SJVC severity and TGA status.
Main Results:
- Patients with TGA showed significantly smaller left and combined IJV caliber compared to controls.
- Higher right-sided and combined SJVC stenosis were significantly associated with TGA.
- A threshold of approximately 70% stenosis in the right or both IJVs emerged as a potential diagnostic indicator.
Conclusions:
- TGA is associated with high-grade SJVC and smaller IJVs.
- MRI assessment of SJVC severity may enhance TGA diagnostic accuracy, especially in unclear cases.
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