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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amnesia is a common clinical problem characterized by four features: (1) normal immediate recall, (2) impaired ability to learn, (3) relatively spared ability to retrieve previously learned material, and (4) preserved cognitive and personality characteristics. Amnesia occurs as a distinct mental disorder, and nine variations seen clinically are described here: Korsakoff's psychosis, posttraumatic amnesia, amnesia stroke, postoperative amnesia, postinfectious amnesia, anoxic amnesia, transient global amnesia following ECT, and psychogenic amnesia. The clinical findings which characterize and differentiate these disorders are presented, along with suggestions for management and a discussion of the the outcome of amnesia.
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PMID:Amnesia. 36 Apr 1

A patient with transient global amnesia also had transient bilateral gaze nystagmus which was detected both by conventional bedside examination and upon electronystagmographic recording. The nystagmus was absent one week later indicating recovery of the temporary brain stem deficit. The recording of objective evidence of brain stem dysfunction in the form of gaze nystagmus in a patient who had transient global amnesia, suggests that both were due to a transient ischemic attack involving the cerebral blood supply in the vertebrobasilar distribution.
Stroke
PMID:Brain stem dysfunction in transient global amnesia. 50 88

Transient global amnesia (TGA) is generally believed to be a transient ischemic attack affecting short-term memory centers. A recent three-year follow-up found a high incidence of subsequent dementia and stroke in patients with TGA. We studied the course (average, 46 months) of 32 patients with TGA and found a low rate of recurrence (12.5%), dementia (6%), or transient ischemic attacks (3%). Transient global amnesia would appear to carry a more benign prognosis than classical transient ischemic attacks.
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PMID:Long-term prognosis in transient global amnesia. 75 58

A 54-year-old woman with transient global amnesia (TGA) was found to have digitalis-induced bradyarrhythmia with atrioventricular dissociation. The amnesia cleared only upon resolution of the arrhythmia. Cardiac arrhythmia has been postulated as a cause, but TGA in the setting of cardiac arrhythmia has not been documented previously. Cardiac arrhythmia should be excluded in patients with TGA, and TGA, a syndrome diagnosed on clinical grounds alone, must be recognized as one possible manifestation of treatable, potentially serious cardiac or cerebrovascular disease.
Stroke
PMID:Transient global amnesia associated with cardiac arrhythmia and digitalis intoxication. 117 59

A case control study of transient global amnesia (TGA), transient ischaemic attacks (TIA) and normal controls is described. Each of the 51 TGA patients, selected between January 1985 and March 1990, was compared with four controls (two TIAs and two normals) for the presence of vascular risk factors (hypertension, diabetes, smoking habits, cholesterol, triglycerides and haematocrit levels, heart disease, previous stroke), previous TGA, migraine, psychiatric illness and recent head trauma. Patients with TGA had less diabetes, hypercholesterolaemia and hypertriglyceridaemia than TIA. TGA subjects had significantly more hypertension (odds ratio = 3.31) and migraine (odds ratio = 8.67) than normal controls. During a mean of 17.4 mths of follow-up (range 1-96 mths), three subjects had recurrent TGA, one sustained a TIA and a minor stroke, but none had seizures. Thrombo-embolism and epilepsy are unlikely to be the cause of this benign disorder. The role is stressed of appropriate precipitants, including haemodynamic changes, and of individual susceptibility (of which migraine is probably a marker) in the genesis of TGA.
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PMID:Transient global amnesia. A case control study. 155 58

A long-term follow-up study was performed on patients with transient global amnesia (TGA) in order to evaluate the prognosis, the recurrence rate and the occurrence of stroke and dementia. 102 patients (57 women, 45 men; mean age 62.8 +/- 9.4 years) were prospectively included and followed up. The follow-up duration ranged between 12 and 241 months with an average value of 82.2 +/- 51.1 (mean +/- SD). The death rate showed no difference from that of sex- and age-matched subjects. TGA recurred in 19 cases (18.63%). Only 4 patients suffered subsequent stroke, and only 3 showed intellectual deterioration. TGA prognosis was shown to be better than that of RIA and lacunar patients.
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PMID:Prognosis of transient global amnesia: a long-term follow-up study. 156 56

Five right-handed patients with pure transient global amnesia were evaluated with technetium-99m hexamethylpropyleneamine oxime single photon emission computed tomography after the amnesic attack. Independent of the interval between the procedure and the amnesic episode, single photon emission computed tomography demonstrated a decreased cerebral blood flow in the left temporal lobe in one patient and in the left parietotemporal region in three patients, with a more marked reduction in the temporal lobe. The remaining three patients were normal. A control single photon emission computed tomographic study was carried out in one patient 3 months after the amnesic attack and showed a left-sided persistent temporal hypoperfusion. These findings suggest that in some patients, transient global amnesia can be due to a vascular mechanism requiring strong investigations for vascular risk factors and appropriate treatment. During a follow-up period of 12 to 32 months, none of the patients with regional hypoperfusion suffered cerebrovascular events, suggesting that single photon emission computed tomography has no predictive value for further stroke.
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PMID:Technetium-99m HM-PAO single photon emission computed tomography imaging in transient global amnesia. 158 Aug 18

Transient global amnesia is often attributed to a seizure, vascular cause, or migraine, but the outcome is usually benign. The presence of migraine and important risk factors for stroke necessitates close patient monitoring. Anti-platelet therapy should be considered.
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PMID:Transient global amnesia. 219 58

The authors have studied 30 patients with transient global amnesia aged between 49 and 76 years (median age of 63 years), without focal neurologic signs that have been followed for periods varying between 6 months and 10 years. Three of the patients had recurrent attacks of transient global amnesia, and another three had a stroke, although at some distance from the amnesia attack. Association was noted with certain risk factors including high blood pressure, and angiopathic changes of the eye fundus (in 50% of the patients), dyslipidemia (in 30%), diabetes (in 10%), and essential polyglobulia (in 7%). Coagulation studies including thrombelastograms were carried out in 22 patients, and demonstrated hypercoagulability in 50% of them. Changes in the arterial wall were noted in 85% of the 14 patients in whom carotid sphygmograms were recorded. The presence of these risk factors could explain the occurrence of cerebrovascular accidents in patients with transient global amnesia. Electroencephalograms performed immediately or a short time after the amnesia attack have evidenced in 18 patients rapid-type dysrhythmia, or diffuse theta waves, predominantly located in the deep layers of the left and right temporal areas. The EEG tracings were either flat or normal in the remaining 12 patients. Of the 30 patients presenting with global transient amnesia only two had migraine in antecedents, and another six had headache during the evolution of amnesia. The neurologic examination did not reveal any abnormality in 27 of the patients. Sequelar signs of neurological deficits were noted in the remaining three patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transient global amnesia (a study of 30 cases)]. 223 8

The risk of recurrency in transient global amnesia was calculated from eight representative studies published in the literature comprising a total of 622 patients, and from a personal survey in 122 patients to be 3.4%/year. Within a mean period of observation of five years, a first recurrency was followed by one further amnesic attack in 1/5 and by two or more attacks in 1/10. Stroke risk proved not to be higher than in a normal population of the respective age groups. A residual syndrome of disturbed long term verbal memory may be seen even after a single attack.
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PMID:[Transient global amnesia. With a contribution to its prognosis]. 267 70


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