Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://www.journalmc.org

Case Report

Volume 15, Number 8, August 2024, pages 159-166

A Case With Bilateral Hippocampal Infarction Resembling Transient Global Amnesia

Figures

Figure 1.
Figure 1. Brain MRI showing multiple old ischemic changes and MR angiography on day 1. (a, b) T2-weighted images with 5-mm-thick brain MRI on day 1 revealed multiple old ischemic changes in both hemispheres. (c, d) Normal MR angiography findings with a patent posterior circulation system. MRI: magnetic resonance imaging; MR: magnetic resonance.
Figure 2.
Figure 2. Brain MRI with 5-mm thickness and 2-mm thin-slice on day 1. (a) DWI with 5-mm-thick brain MRI on day 1 revealed no abnormalities. (b) ADC with 5-mm-thick brain MRI on day 1 revealed no abnormalities. (c) DWI with 2-mm thin-slice brain MRI on day 1 revealed two hippocampal signal high lesions each on both sides (white arrowheads). (d) ADC with 2-mm thin-slice brain MRI on day 1 revealed signal losses for the two DWI-high hippocampal lesions (white arrowheads). MRI: magnetic resonance imaging; ADC: apparent diffusion coefficient; DWI: diffusion-weighted imaging.
Figure 3.
Figure 3. Brain MRI with 2-mm thin-slice on day 2. (a) DWI with 2-mm thin-slice brain MRI on day 2 revealed persistent punctate hyperintense DWI signals in the left hippocampus (white arrowhead). (b) ADC with 2-mm thin-slice brain MRI on day 2 revealed persistent punctate signal loss in the left hippocampus (white arrowhead). (c) DWI with 2-mm thin-slice brain MRI on day 2 revealed persistent high signals in the right hippocampus (white arrowhead). (d) ADC with 2-mm thin-slice brain MRI on day 2 revealed persistent signal loss in the right hippocampus (white arrowhead). MRI: magnetic resonance imaging; ADC: apparent diffusion coefficient; DWI: diffusion-weighted imaging.
Figure 4.
Figure 4. Brain MRI with 5-mm thickness on day 7. (a) DWI with 5-mm-thick brain MRI on day 7 revealed persistent high signals in the left hippocampus (white arrowhead), increasing the probability of hippocampal infarction. (b) ADC with 5-mm-thick brain MRI on day 7 revealed persistent signal loss in the left hippocampus (white arrowhead). (c) DWI with 5-mm-thick brain MRI on day 7 revealed persistent vague high signals in the right hippocampus (white arrowhead). (d) ADC with 5-mm-thick brain MRI on day 7 revealed no apparent signal loss, suggesting that cellular damages were milder on this side. MRI: magnetic resonance imaging; ADC: apparent diffusion coefficient; DWI: diffusion-weighted imaging.

Table

Table 1. Results of the Wechsler Memory Scale-Revised Test (WMS-R) on Day 12
 
SubtestsI (immediate recall)II (delayed recall)
The obtained results with WMS-R revealed a slightly prolonged time in verbal memorization tasks, but they could be recalled once they are memorized successfully. The results indicated that the patient may experience a slight difficulty in remembering new tasks, which may not be a significant disturbance in the daily living and working. aForward task scores in the second column and backward task scores in the third column.
  Information and orientation14/14
  Mental control6/6
  Figure memory8/10
  Logical memory (A)14/2514/25
  Logical memory (B)10/259/25
  Visual paired associates14/186/6
  Verbal paired associates (related/easy)12/124/4
  Verbal paired associates (unrelated/difficult)2/124/4
  Visual reproduction40/4141/41
  Digital spana(Forward) 10/12(Backward) 10/12
  Visual memory spana(Forward) 12/14(Backward) 6/12
Subscale scores
  Verbal memory indicator102
  Visual memory indicator113
  General memory indicator106
  Delayed recall indicator128
  Attention/concentration indicator120