Ott B R, Saver J L
Roger Williams Medical Center, Providence, RI 02908.
Stroke. 1993 Jul;24(7):1033-42. doi: 10.1161/01.str.24.7.1033.
Although persistent amnesia due to bilateral limbic system infarction is well described, reports of amnesic syndromes due to unilateral stroke have appeared infrequently and unsystematically. We report six new cases and review previously published reports to expand and consolidate knowledge regarding amnesic stroke.
Six patients developed acute amnesia associated with unilateral stroke. Brain computed tomography or magnetic resonance imaging revealed lesions in limbic structures, which accounted for the memory deficit. Based on these as well as similar cases in the literature, we delineate three distinct syndromes of unilateral amnesic stroke involving the territories of the posterior cerebral, anterior choroidal, and thalamic penetrating arteries. Eighty-five percent of reported cases have involved the left hemisphere.
Persistent as well as transient amnesia may be the sole or primary manifestation of unilateral hemispheric stroke. The vascular mechanisms of amnesic stroke are diverse. Patients presenting with acute amnesia possibly related to cerebral ischemia should be classified by documented or presumed lesion site as well as the involved vascular territory. Left amygdalohippocampal or diencephalic dysfunction may produce a particular vulnerability to global amnesia.
尽管双侧边缘系统梗死所致的持续性失忆已有详尽描述，但单侧卒中所致失忆综合征的报道却罕见且不系统。我们报告6例新病例，并回顾既往发表的报道，以拓展和巩固关于失忆性卒中的认识。
6例患者发生与单侧卒中相关的急性失忆。脑部计算机断层扫描或磁共振成像显示边缘结构有病变，这导致了记忆缺陷。基于这些病例以及文献中的类似病例，我们明确了三种不同的单侧失忆性卒中综合征，累及大脑后动脉、脉络膜前动脉和丘脑穿通动脉供血区。报道病例的85%累及左半球。
持续性及短暂性失忆可能是单侧半球卒中的唯一或主要表现。失忆性卒中的血管机制多种多样。出现可能与脑缺血相关的急性失忆的患者，应根据记录或推测的病变部位以及受累血管供血区进行分类。左侧杏仁核海马或间脑功能障碍可能会使患者特别容易发生全面性失忆。
