急性遗忘综合征与缺血性卒中：病例系列
Acute Amnestic Syndrome and Ischemic Stroke: A Case Series.
作者信息
Ghannam Malik, Alshaer Qasem, Ukatu Hope, Alkuwaiti Mohammed, Streib Christopher
机构信息
Department of Neurology (MG, HU, MA, CS), University of Minnesota, Minneapolis; and Department of Neurology (QA), Emory University, Atlanta, GA.
出版信息
Neurol Clin Pract. 2021 Jun;11(3):263-267. doi: 10.1212/CPJ.0000000000000928.
PURPOSE OF REVIEW
Stroke is an uncommon cause of amnesia. We describe in detail 3 cases of anterograde amnesia and confabulation secondary to acute ischemic stroke and review the available literature.
RECENT FINDINGS
In our case series, all 3 patients presented with anterograde amnesia and 2 of 3 copresented with prominent confabulation. These symptoms were recognized in delayed fashion, and no patients received IV tissue plasminogen activator (tPA). Although stroke infarct topology was variable, all 3 patients had infarction of the fornix. Long-term follow-up was obtained in 2 of 3 patients: both had persistent memory impairment and were no longer functionally independent.
SUMMARY
Acute onset anterograde amnesia and confabulation may uncommonly represent acute ischemic stroke. Delays in this diagnosis typically exclude patients from emergent stroke treatment or timely diagnostic stroke evaluation. Clinicians should maintain a high degree of suspicion for ischemic stroke in this setting, especially in patients with comorbid vascular risk factors. Memory impairment secondary to ischemic stroke can produce considerable long-term disability.
综述目的
中风是失忆症的一种罕见病因。我们详细描述了3例继发于急性缺血性中风的顺行性失忆和虚构症病例，并回顾了现有文献。
最新发现
在我们的病例系列中，所有3例患者均表现为顺行性失忆，3例中有2例同时伴有明显的虚构症。这些症状发现较晚，且所有患者均未接受静脉注射组织纤溶酶原激活剂（tPA）治疗。尽管中风梗死的部位各异，但所有3例患者的穹窿均发生了梗死。3例患者中有2例进行了长期随访：两人均存在持续性记忆障碍，且不再具备功能独立性。
总结
急性起病的顺行性失忆和虚构症可能罕见地表现为急性缺血性中风。这种诊断的延迟通常会使患者无法接受紧急中风治疗或及时进行诊断性中风评估。在此情况下，临床医生应高度怀疑缺血性中风，尤其是对于伴有血管危险因素的患者。缺血性中风继发的记忆障碍可导致严重的长期残疾。
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