Huber R, Aschoff A J, Ludolph A C, Riepe M W
Department of Neurology, University of Ulm, Steinhövelstr. 1, 89075 Ulm, Germany.
J Neurol. 2002 Nov;249(11):1520-4. doi: 10.1007/s00415-002-0881-3.
The etiology of Transient Global Amnesia (TGA) is still obscure. Diffusion-Weighted-Imaging (DWI) provides conflicting evidence concerning a possible vascular ischemic cause in mesiotemporal structures including the hippocampal region. The question remains open whether conflicting observations resulted from different observation times. DWI was performed at a time interval with known sensitivity for detection of ischemia. Ten patients (5 male, 5 female; mean age of 63 +/- 9, range 41-71 years) with typical TGA were investigated at an average delay of 18 hours (range 6 to 44 hours) between onset of symptoms and magnetic resonance imaging (transversal DW-, T1W- and T2W-MRI). Five patients received apparent-diffusion-coefficient (ADC)-mapping. Cerebrovascular studies (ECG, TTE and extra/transcranial dopplersonographic and duplexultrasonic investigation) and EEG were normal in all patients. DW-MRI-sequences and ADC-maps, if performed, were normal in all patients. Conventional T2W-MRI in 3 out of 10 patients showed microangiopathic subcortical changes and lacunar strokes of older origin. We conclude that TGA does not result from a vascular ischemic etiology in the majority of cases.
短暂性全面性遗忘症（TGA）的病因仍不明确。弥散加权成像（DWI）对于包括海马区在内的颞叶内侧结构可能存在的血管缺血性病因提供了相互矛盾的证据。关于相互矛盾的观察结果是否源于不同的观察时间，这个问题仍然没有答案。DWI是在对检测缺血具有已知敏感性的时间间隔内进行的。对10例典型TGA患者（5例男性，5例女性；平均年龄63±9岁，范围41 - 71岁）进行了研究，症状发作与磁共振成像（横向DWI、T1WI和T2WI）之间的平均延迟时间为18小时（范围6至44小时）。5例患者进行了表观扩散系数（ADC）成像。所有患者的脑血管检查（心电图、经胸超声心动图以及经颅和颅外多普勒超声和双功超声检查）和脑电图均正常。所有患者的DWI - MRI序列和ADC图（如果进行了此项检查）均正常。10例患者中有3例的常规T2WI - MRI显示有微血管病性皮质下改变和陈旧性腔隙性脑梗死。我们得出结论，在大多数情况下，TGA并非由血管缺血性病因引起。
