Dement Neurocogn Disord.  2017 Sep;16(3):87-90. 10.12779/dnd.2017.16.3.87.

Hippocampal Lesions of Diffusion Weighted Magnetic Resonance Image in Patients with Headache without Symptoms of Transient Global Amnesia

• Park JH
• Oh CG
• Kim SH
• Lee SH
• Jang JW

• KMID: 2442822
• DOI: http://doi.org/10.12779/dnd.2017.16.3.87

Abstract

BACKGROUND
The dot-like hippocampal signal intensity in diffusion-weighted MR images is well-known as a characteristic imaging feature in transient global amnesia, a neurological syndrome in which sudden forward-and-backward memory loss occurs that is slowly recovered within 24 hours. We here report on patients with this dot-like hippocampal hyperintensity who did not present with anterograde amnesia except for headaches.
CASE REPORT
Two women without a specific medical history presented with sudden-onset headaches on the same day. Neither had any trauma or infection history before the symptom or any sudden emotional or postural changes. Brain MRI showed tiny hippocampal high signal intensity on diffusion-weighted images (DWI).
CONCLUSIONS
Dot-like hippocampal lesions seen on DWI may be present without memory impairment, and more studies are needed to determine whether there is any association with headache as in this case.

Keyword

transient global amnesia; hippocampus; diffusion-weighted magnetic resonance image

MeSH Terms

Amnesia, Anterograde
Amnesia, Transient Global*
Brain
Diffusion*
Female
Headache*
Hippocampus
Humans
Magnetic Resonance Imaging
Memory
Memory Disorders

Figure

• 

  Fig. 1 Hippocampal hyperintensity in diffusion-weighted imaging in case 1. A: Diffusion-weighted images. B: Apparent diffusion coefficient.

• 

  Fig. 2 Hippocampal hyperintensity in diffusion-weighted imaging in case 2. A: Diffusion-weighted images. B: Apparent diffusion coefficient.

Reference

1. Förster A, Griebe M, Gass A, Kern R, Hennerici MG, Szabo K. Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus. Cerebrovasc Dis. 2012; 33:104–115.

2. Weon YC, Kim JH, Lee JS, Kim SY. Optimal diffusion-weighted imaging protocol for lesion detection in transient global amnesia. AJNR Am J Neuroradiol. 2008; 29:1324–1328.

3. Bartsch T, Deuschl G. Transient global amnesia: functional anatomy and clinical implications. Lancet Neurol. 2010; 9:205–214.

4. Kritchevsky M, Zouzounis J, Squire LR. Transient global amnesia and functional retrograde amnesia: contrasting examples of episodic memory loss. Philos Trans R Soc Lond B Biol Sci. 1997; 352:1747–1754.

5. Quinette P, Guillery-Girard B, Dayan J, de la Sayette V, Marquis S, Viader F, et al. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain. 2006; 129(Pt 7):1640–1658.

6. Bartsch T, Alfke K, Stingele R, Rohr A, Freitag-Wolf S, Jansen O, et al. Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain. 2006; 129(Pt 11):2874–2884.

7. Williamson J, Larner AJ. Transient global amnesia. Br J Hosp Med (Lond). 2015; 76:C186–C188.

8. Donnet A. Transient global amnesia triggered by migraine in a French Tertiary-Care Center: an 11-year retrospective analysis. Headache. 2015; 55:853–859.

9. Förster A, Al-Zghloul M, Wenz H, Böhme J, Groden C, Neumaier-Probst E. Isolated punctuate hippocampal infarction and transient global amnesia are indistinguishable by means of MRI. Int J Stroke. 2017; 12:292–296.

10. Jeong M, Jin J, Kim JH, Moon Y, Choi JW, Kim HY. Incidental hippocampal hyperintensity on diffusion-weighted MRI: individual susceptibility to transient global amnesia. Neurologist. 2017; 22:103–106.

11. Frisoni GB. PET and 18F ligands in the diagnosis of Alzheimer's disease. Lancet Neurol. 2011; 10:397–399.

12. Pantoni L, Lamassa M, Inzitari D. Transient global amnesia: a review emphasizing pathogenic aspects. Acta Neurol Scand. 2000; 102:275–283.

13. Menéndez González M, Rivera MM. Transient global amnesia: increasing evidence of a venous etiology. Arch Neurol. 2006; 63:1334–1336.

14. Park YH, Jang JW, Yang Y, Kim JE, Kim S. Reflections of two parallel pathways between the hippocampus and neocortex in transient global amnesia: a cross-sectional study using DWI and SPECT. PLoS One. 2013; 8:e67447.