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Images in Neurology |

Transient Global Amnesia Concordant Hippocampal Abnormalities on Positron Emission Tomography and Magnetic Resonance Imaging

Victoria Gonzalez-Martinez, MD; Frédéric Comte, MD; Delphine de Verbizier, MD; Bertrand Carlander, MD
Arch Neurol. 2010;67(4):510-511. doi:10.1001/archneurol.2010.50.
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A 60-year-old woman was admitted 90 minutes after the onset of a typical transient global amnesia (TGA) episode, shortly after sexual intercourse. Anterograde amnesia was isolated and lasted less than 12 hours, with acute onset and progressive recovery. This patient had been referred 6 years before for a typical TGA, also postcoital. She regularly had moderate-intensity postcoital headaches.

Immediate fluorodeoxyglucose positron emission tomography (PET) scan (Figure 1A) revealed a pronounced left hippocampal hypometabolism (radiotracer was injected 2 hours after the onset of the symptoms). Magnetic resonance imaging (MRI) was performed 48 hours after TGA onset and showed a small nodular hyperintensity on diffusion-weighted imaging, with reduction of the apparent diffusion coefficient, in the left hippocampus (Figure 2). Fluid-attenuated inversion recovery and T2-weighted sequences were normal.

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Figure 1.

Positron emission tomography images. A, The axial and coronal planes, from left to right, obtained 2 hours after transient global amnesia onset, showing hypometabolism in the left hippocampal region (arrows). B, Control images obtained 1 year later (arrowheads, same location).

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Figure 2.

Diffusion-weighted magnetic resonance image, obtained 48 hours after onset, revealing a small diffusion restriction in the posterior left hippocampus (arrow).

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