Transient Global Amnesia

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Presentation transcript:

Transient Global Amnesia Julieta E. Arena, MD, Alejandro A. Rabinstein, MD Mayo Clinic Proceedings Volume 90, Issue 2, Pages 264-272 (February 2015) DOI: 10.1016/j.mayocp.2014.12.001 Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 The Papez circuit of short-term memory. The hippocampus on each side projects to the septal areas via the fornix, then to the mammillary bodies, the anterior nucleus of the thalamus, the cingulate gyrus of the frontal lobe, and back to the hippocampus. Mayo Clinic Proceedings 2015 90, 264-272DOI: (10.1016/j.mayocp.2014.12.001) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Diagnostic algorithm for a patient presenting with sudden onset anterograde amnesia. ECG = electrocardiography; EEG = electroencephalography; MRI = magnetic resonance imaging; TEA = transient epileptic amnesia; TGA = transient global amnesia. Mayo Clinic Proceedings 2015 90, 264-272DOI: (10.1016/j.mayocp.2014.12.001) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Venous hypothesis for the pathogenesis of transient global amnesia (TGA). It is proposed that retrograde venous flow and the ensuing venous hypertension could explain the occurrence of TGA. Increased intrathoracic pressure, as caused by a Valsalva maneuver, could trigger retrograde venous flow in patients with valve incompetence in the internal jugular veins. The resulting venous congestion would preferentially affect the function of the medial temporal lobes, thus inciting the anterograde amnesia. The graphic on the right illustrates the venous blood drainage from the medial temporal lobes. Blood from the temporal lobes is drained by the basal veins of Rosenthal and the internal cerebral veins, which, in turn, drain into the vein of Galen, and from there to the straight sinus, confluens, transverse sinuses, and sigmoid sinuses, and, finally, into the internal jugular veins. Mayo Clinic Proceedings 2015 90, 264-272DOI: (10.1016/j.mayocp.2014.12.001) Copyright © 2015 Mayo Foundation for Medical Education and Research Terms and Conditions