Harase Shohei, Araki Kunihiko, Kobayashi Tetsuya, Katada Fumiaki, Fukutake Toshio
Department of Neurology, Kameda Medical Center.
Department of Cardiology, Kameda Medical Center.
Rinsho Shinkeigaku. 2021 Feb 23;61(2):136-139. doi: 10.5692/clinicalneurol.cn-001502. Epub 2021 Jan 26.
A 66-year-old woman with a history of hypertension complained about sudden short-term memory loss. On arrival to our outpatient clinic, she was alert and oriented and did not have chest pain or shortness of breath. Neurological and neuropsychological examinations were within normal limits. In light of a transient anterograde amnestic attack and no neurological focal deficit, we clinically diagnosed transient global amnesia (TGA). To confirm whether there was an intracranial lesion or not, diffusion-weighted MRI of the brain was performed, and revealed hyper-intense lesions in the left hippocampus and right corpus callosum. Consequently, the patient was admitted to our hospital on follow-up for suspected cerebral infarction. On day 1, laboratory tests indicated an elevated troponin I level, and electrocardiogram revealed an inverted T wave in the inferior leads. Coronary angiography on day 9 of admission demonstrated severe stenosis of the right coronary artery, leading to a diagnosis of non-ST elevation myocardial infarction. Although TGA itself typically has a favorable prognosis, clinicians should consider potential concurrent painless myocardial infarction in patients with TGA.
一位有高血压病史的66岁女性主诉突发短期记忆力丧失。到我们门诊就诊时,她神志清醒、定向力正常,没有胸痛或呼吸急促症状。神经学和神经心理学检查均在正常范围内。鉴于有短暂的顺行性遗忘发作且无神经局灶性缺损,我们临床诊断为短暂性全面性遗忘症(TGA)。为确认是否存在颅内病变,进行了脑部弥散加权磁共振成像(MRI),结果显示左侧海马体和右侧胼胝体有高信号病变。因此,该患者因疑似脑梗死在随访中被收入我院。入院第1天,实验室检查显示肌钙蛋白I水平升高,心电图显示下壁导联T波倒置。入院第9天进行的冠状动脉造影显示右冠状动脉严重狭窄,导致诊断为非ST段抬高型心肌梗死。尽管TGA本身通常预后良好,但临床医生应考虑TGA患者可能并发无痛性心肌梗死。