Epiduroscopy (EDS) allows diagnosis and treatment of spinal nerve root pathology by a fiberoptic device inserted percutaneously in the epidural space. Transient global amnesia syndrome (TGA) is defined by an abrupt on...Epiduroscopy (EDS) allows diagnosis and treatment of spinal nerve root pathology by a fiberoptic device inserted percutaneously in the epidural space. Transient global amnesia syndrome (TGA) is defined by an abrupt onset of an anterograde and retrograde amnesia that lasts up to 24 h, although mild subclinical neuropsychological deficits, with concomitant vegetative symptoms, can last for days after the episode. To our knowledge no cases of TGA in association with EDS have been recognized. We present a case of a 54-year-old man who was admitted for EDS, having experienced two times the failed surgery for spinal and left leg pain. During the EDS, 10 ml of non-ionic contrast media (CM) was injected to confirm the inside lesions. The epidural adhesions were gently broken down and drugs were injected around any inflamed nerve roots. Immediately after EDS, the patient experienced a TGA with loss of memory for the recent procedure and an impaired ability to retain new information. There were no signs of confusion or altered conscious level or seizure activities and neurological examination was normal. At 24 h a cranial computerized tomography (cCT) without CM showed “abnormal contrast enhancement at subarachnoid liquoral spaces levels”, then at 72 h cCT control was normal. The patient was discharged on the seventh day with perioperative lacunar amnesia persisting at this time. Herein, we sought a possible relationship between neurotoxic effect of CM and TGA in a patient emotionally stressed, even if the CM dose was given as a normal clinical range.展开更多
OBJECTIVE: To study cognitive function and cerebral metabolic changes in patients with transient global amnesia (TGA). METHODS: Three patients with TGA were given mini-mental state examination (MMSE), revised Wechsler...OBJECTIVE: To study cognitive function and cerebral metabolic changes in patients with transient global amnesia (TGA). METHODS: Three patients with TGA were given mini-mental state examination (MMSE), revised Wechsler memory scale (WMS-R) examination and magnetic resonance imaging (MRI) scans after they had been diagnosed as TGA. Using (18)F labelled deoxyglucose as tracer, patients were given a positron emission tomography (PET) examination at different periods during recovery. RESULTS: No obvious abnormality was found in MMSE and MRI scans in the three patients. However, WMS-R examination and cerebral PET imaging displayed cognitive dysfunction of varying degrees and low metabolism in local areas related to memory in 2 of 3 patients. CONCLUSIONS: In TGA patients, cognitive function and cerebral metabolic levels are closely correlated with duration of symptoms. It is necessary to stop the TGA attack as quickly as possible early time.展开更多
目的探究短暂性全面性遗忘症(transient global amnesia,TGA)伴海马损伤患者的临床、血管危险因素及神经心理因素特征。方法回顾性纳入2015年1月—2024年1月海军军医大学第一附属医院收治的TGA患者,统计TGA伴海马损伤的部位及发病至完...目的探究短暂性全面性遗忘症(transient global amnesia,TGA)伴海马损伤患者的临床、血管危险因素及神经心理因素特征。方法回顾性纳入2015年1月—2024年1月海军军医大学第一附属医院收治的TGA患者,统计TGA伴海马损伤的部位及发病至完成头颅MRI的时间。根据是否伴有海马损伤将TGA患者分为TGA伴海马损伤组和TGA不伴海马损伤组,比较两组患者之间血管危险因素、小血管标志物、大血管狭窄程度、神经心理量表评估结果的差异。结果共纳入72例患者,平均年龄(63.7±11.7)岁,男性27例(37.5%),伴有海马损伤者21例(29.2%)。TGA伴海马损伤主要累及海马体部(57.1%),患者发病后3~<5 d完成头颅MRI的海马损伤检出率较高(42.9%)。与TGA不伴海马损伤组相比,TGA伴海马损伤组高血压(76.2%vs.49.0%,P=0.034)、发病1周内完成头颅MRI(95.2%vs.66.7%,P=0.025)、中重度白质高信号(38.1%vs.11.8%,P=0.025)以及脑室旁白质高信号3分(33.3%vs.9.8%,P=0.037)的比例均显著较高,而HAMA评分(3.0分vs.7.0分,P=0.008)和焦虑状态比例(4.8%vs.29.4%,P=0.048)显著更低。结论海马损伤是部分TGA患者的特征性影像学标志物,可能与高血压和小血管损伤有关。不伴海马损伤的TGA则可能与神经心理因素有关。展开更多
文摘Epiduroscopy (EDS) allows diagnosis and treatment of spinal nerve root pathology by a fiberoptic device inserted percutaneously in the epidural space. Transient global amnesia syndrome (TGA) is defined by an abrupt onset of an anterograde and retrograde amnesia that lasts up to 24 h, although mild subclinical neuropsychological deficits, with concomitant vegetative symptoms, can last for days after the episode. To our knowledge no cases of TGA in association with EDS have been recognized. We present a case of a 54-year-old man who was admitted for EDS, having experienced two times the failed surgery for spinal and left leg pain. During the EDS, 10 ml of non-ionic contrast media (CM) was injected to confirm the inside lesions. The epidural adhesions were gently broken down and drugs were injected around any inflamed nerve roots. Immediately after EDS, the patient experienced a TGA with loss of memory for the recent procedure and an impaired ability to retain new information. There were no signs of confusion or altered conscious level or seizure activities and neurological examination was normal. At 24 h a cranial computerized tomography (cCT) without CM showed “abnormal contrast enhancement at subarachnoid liquoral spaces levels”, then at 72 h cCT control was normal. The patient was discharged on the seventh day with perioperative lacunar amnesia persisting at this time. Herein, we sought a possible relationship between neurotoxic effect of CM and TGA in a patient emotionally stressed, even if the CM dose was given as a normal clinical range.
文摘OBJECTIVE: To study cognitive function and cerebral metabolic changes in patients with transient global amnesia (TGA). METHODS: Three patients with TGA were given mini-mental state examination (MMSE), revised Wechsler memory scale (WMS-R) examination and magnetic resonance imaging (MRI) scans after they had been diagnosed as TGA. Using (18)F labelled deoxyglucose as tracer, patients were given a positron emission tomography (PET) examination at different periods during recovery. RESULTS: No obvious abnormality was found in MMSE and MRI scans in the three patients. However, WMS-R examination and cerebral PET imaging displayed cognitive dysfunction of varying degrees and low metabolism in local areas related to memory in 2 of 3 patients. CONCLUSIONS: In TGA patients, cognitive function and cerebral metabolic levels are closely correlated with duration of symptoms. It is necessary to stop the TGA attack as quickly as possible early time.
文摘目的探究短暂性全面性遗忘症(transient global amnesia,TGA)伴海马损伤患者的临床、血管危险因素及神经心理因素特征。方法回顾性纳入2015年1月—2024年1月海军军医大学第一附属医院收治的TGA患者,统计TGA伴海马损伤的部位及发病至完成头颅MRI的时间。根据是否伴有海马损伤将TGA患者分为TGA伴海马损伤组和TGA不伴海马损伤组,比较两组患者之间血管危险因素、小血管标志物、大血管狭窄程度、神经心理量表评估结果的差异。结果共纳入72例患者,平均年龄(63.7±11.7)岁,男性27例(37.5%),伴有海马损伤者21例(29.2%)。TGA伴海马损伤主要累及海马体部(57.1%),患者发病后3~<5 d完成头颅MRI的海马损伤检出率较高(42.9%)。与TGA不伴海马损伤组相比,TGA伴海马损伤组高血压(76.2%vs.49.0%,P=0.034)、发病1周内完成头颅MRI(95.2%vs.66.7%,P=0.025)、中重度白质高信号(38.1%vs.11.8%,P=0.025)以及脑室旁白质高信号3分(33.3%vs.9.8%,P=0.037)的比例均显著较高,而HAMA评分(3.0分vs.7.0分,P=0.008)和焦虑状态比例(4.8%vs.29.4%,P=0.048)显著更低。结论海马损伤是部分TGA患者的特征性影像学标志物,可能与高血压和小血管损伤有关。不伴海马损伤的TGA则可能与神经心理因素有关。
