Piñol-Ripoll G, de la Puerta González-Miró I, Martínez L, Alberti-González O, Santos S, Pascual-Millán L F, Mauri-Llerda J A, Mostacero E
Hospital Clínico de Zaragoza, Zaragoza, España.
Rev Neurol. 2005;41(9):513-6.
Transient global amnesia (TGA) is a clinical condition that has been described in many studies, but its pathophysiology is not fully understood. In recent years the theory of valvular insufficiency in the jugular vein has been added to the classical hypotheses that link it to migraine, to epilepsy and -the most widely accepted- to transient ischemic attacks (TIA), although the real origin of the condition has still not been determined.
In a retrospective study we compared 131 patients diagnosed with TGA between 1993 and 2004 with 262 patients who were diagnosed as having TIA over the same period.
Mean age was 65.94 years in TGA versus 71.11 years in the case of TIA. There was a higher rate of arterial hypertension among the patients with TGA and diabetes mellitus was more frequent among those with TIA (p<0.05 in both cases). Emboligenic heart disease was scarce among patients with TGA. The number of patients with a history of ischaemic heart disease and a history and the development of cerebrovascular diseases was greater among those with TIA than in cases of TGA (p<0.05). The TGA recurrence rate was 12%. The percentage of pathological findings in the CAT brain scan was higher in patients with TIA (p<0.05). There are no significant differences between patients with TGA and TIA as far as treatment on hospital discharge is concerned.
TGA does not seem to be a symptom of an arteriosclerotic pathology nor does it appear to offer a higher risk of heart or cerebrovascular disease and, therefore, antiaggregating therapy would not be indicated in such cases.
短暂性全面性遗忘症(TGA)是一种在许多研究中都有描述的临床病症,但其病理生理学尚未完全明确。近年来,颈静脉瓣功能不全理论被纳入到将其与偏头痛、癫痫以及(最广泛接受的)短暂性脑缺血发作(TIA)相联系的经典假说中,尽管该病症的真正病因仍未确定。
在一项回顾性研究中,我们将1993年至2004年间诊断为TGA的131例患者与同期诊断为TIA的262例患者进行了比较。
TGA患者的平均年龄为65.94岁,而TIA患者为71.11岁。TGA患者中动脉高血压的发生率较高,而TIA患者中糖尿病更为常见(两者均p<0.05)。TGA患者中栓塞性心脏病较少见。有缺血性心脏病病史以及有脑血管疾病病史和发病的患者在TIA患者中比TGA患者更多(p<0.05)。TGA的复发率为12%。TIA患者脑部计算机断层扫描(CAT)的病理发现百分比更高(p<0.05)。就出院时的治疗而言,TGA患者和TIA患者之间没有显著差异。
TGA似乎不是一种动脉硬化性病理的症状,也似乎不会带来更高的心脏或脑血管疾病风险,因此,在此类病例中不建议进行抗聚集治疗。