Acute global amnesia as an exclusive presenting symptom ofthalamic infarct: a diagnostic challenge
INTRODUCTION.
Acute amnesiaGlobal amnesiaIschaemic strokeLacunar strokeThalamic amnesiaThalamic infarct
INTRODUCTION.
Isolated acute amnesia is an exceptional presenting symptom
of thalamic stroke. This study analyses the clinical profile, the diagnosis,
the treatment and the prognosis of these patients. CASE REPORTS. We conducted a
retrospective review of the cases of thalamic infarct that presented
exclusively as acute amnesia in our university tertiary hospital (n = 3) and a
review of similar cases in PubMed (n = 20). 48% presented at least one risk
factor of stroke (arterial hypertension, dyslipidaemia, diabetes mellitus,
atrial fibrillation or a previous stroke). Amnesia was anterograde in three
cases (13%) and global in the remaining 20 (87%). The infarct was detected in
neuroimaging studies carried out within the first 24 hours in one patient (4%)
and later in all the others; the average time until a diagnosis was established
was 11 days. The initial CT scan was normal in five patients (22%). Eight cases
(35%) required magnetic resonance imaging to detect the infarct. Of these, four
subjects were studied directly with MR imaging. Amnesia clearly improved in
eight patients (35%), and three of them (13%) made a full recovery. Fifteen
patients (65%) presented mnemonic sequelae that interfered with their
functional capacity. The clinical picture lasted less than 24 hours in two
patients (9%). None of the cases received revasculisation therapy in the acute
phase. CONCLUSION. The diagnosis of thalamic infarcts that begin exclusively
with amnesia is very difficult and this has negative repercussions on their
treatment in the acute phase. These infarcts can produce a functionally
disabling memory deficit in a high percentage of patients.
Acute amnesiaGlobal amnesiaIschaemic strokeLacunar strokeThalamic amnesiaThalamic infarct
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