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[双侧穹窿病变所致单纯性顺行性遗忘症]

[Pure anterograde amnesia due to bilateral fornix lesions].

作者信息

Araki S, Kawamura M, Shiota J, Kasahata N, Sugita K

机构信息

Department of Neurology, Ushioda General Hospital.

出版信息

Rinsho Shinkeigaku. 1994 Oct;34(10):1031-5.

PMID:7834948
Abstract

The patient was a right-handed 59-year-old female technician who was admitted to our hospital with a complaint of memory loss. Clinical examination revealed pure anterograde amnesia regarding episodic memory, while semantic and procedural memory was intact. Radiological procedures (CT scan and MRI) revealed a tumor of the septum pellucidum, which localized from the lower part of the corpus callosum to the anterior parts of the bilateral fornices. Transcallosal total removal was performed (pathological examination revealed that it was astrocytoma). Radiological and operative findings showed that the thalamus, the mammillary bodies, the hippocampus, and the basal forebrain, which are closely related to memory, were spared. After the operation, she reported no further memory disturbance. Preoperative neuropsychological tests revealed anterograde amnesia for verbal and visual stimuli, but postoperatively the former disappeared and the latter improved. Pre- and postoperatively, she was nonaphasic, and her immediate memory, intelligence, and frontal functions were intact. Cases of amnesia due only to fornix lesions are rare, and have not been reported yet in Japan. Our case is valuable in terms of showing that only the fornix lesion was responsible for memory disturbance. The main symptom resulting from fornix lesion is thought to be anterograde amnesia.

摘要

患者为一名59岁的右利手女性技术员,因记忆力减退入院。临床检查发现其情景记忆存在单纯的顺行性遗忘,而语义记忆和程序性记忆完好。影像学检查(CT扫描和MRI)显示透明隔肿瘤,其位置从胼胝体下部至双侧穹窿前部。行经胼胝体全切除术(病理检查显示为星形细胞瘤)。影像学和手术结果显示,与记忆密切相关的丘脑、乳头体、海马和基底前脑均未受影响。术后,她报告无进一步的记忆障碍。术前神经心理学测试显示对言语和视觉刺激存在顺行性遗忘,但术后前者消失,后者有所改善。术前和术后,她均无失语,即刻记忆、智力和额叶功能均正常。仅因穹窿病变导致失忆的病例罕见,在日本尚未见报道。我们的病例在表明仅穹窿病变是记忆障碍的原因方面具有价值。穹窿病变导致的主要症状被认为是顺行性遗忘。

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