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Transient global amnesia and hippocampal diffusion restriction: an overlooked radiological finding

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Abstract

Transient global amnesia (TGA) is characterized by isolated sudden anterograde amnesia. Diffusion restriction can be observed in the hippocampus on DWI-MRI at varying rates in TGA patients. This study analyzes the prevalence and characteristics of the hippocampal diffusion restriction (HDR), its relationship with vascular risk factors, and the prevalence of lesions overlooked in routine reports. 91 patients diagnosed with TGA at a tertiary hospital between 2011 and 2022 were evaluated retrospectively. The mean age was 64.8 ± 7.3 years, and 63.7% of patients were female. 75.8% of the patients had at least one vascular risk factor. Focal diffusion restriction was detected in 17 patients (18.5%) on DWI-MRI, with only one being extra-hippocampal. 81.2% of HDR was detected when DWI-MRI scan was performed between 12 and 96 h after the onset of symptoms. HDR was detected most when the imaging was performed in 24 to 48 h (p = 0.03). There was no correlation between the duration of symptoms and the detection rates of HDR (p = 0.55). In 9 patients (53% of 17) diffusion restriction was not specified in routine radiology reports. Although focal ischemia, venous flow abnormalities, migraine and epileptic phenomena have been suggested in its etiology, TGA is a clinical condition of which pathophysiology has not been determined clearly. Signal changes observed in DWI-MRI has led to discussions that cerebrovascular etiology may play a role, yet more comprehensive studies are required to prevent and manage TGA. HDRs can be overlooked in routine reports. Therefore, the DWI-MRI images of patients with TGA should be examined vigilantly.

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The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

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Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, Başkent University, Ankara, Turkey

    Ilkin Iyigundogdu, Zeynep Kaya, Guven Girgin, Berna Alkan & Eda Derle

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  1. Ilkin Iyigundogdu
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  2. Zeynep Kaya
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  3. Guven Girgin
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  4. Berna Alkan
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  5. Eda Derle
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Contributions

II and ED conceptualized and designed the study. II, ZK, GG, and BA gathered and analyzed the data. ED supervised the analyses. II, ZK, and ED wrote the manuscript. All authors read and commented on the manuscript critically.

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Correspondence to Eda Derle.

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The authors declare no conflict of interest.

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The work has not been published previously, it is not under consideration for publication elsewhere, its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright-holder.

This study was approved by Research Committee and Ethics Committee of Baskent University (project No: KA 123/176).

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Iyigundogdu, I., Kaya, Z., Girgin, G. et al. Transient global amnesia and hippocampal diffusion restriction: an overlooked radiological finding. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02485-1

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