Transient global amnesia caused by painless aortic dissection

Mondon, Karl; Bléchet, Claire; Gochard, A.; Elaroussi, Djilali; Fetissof, F; Toffol, Bertrand de; Autret, A; Hommet, Caroline

doi:10.1136/emj.2006.040881

Cited by 20 publications

(14 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While in patients with TGA-plus syndrome (TGA and additional minor neurological symptoms) transient ischemic amnesia is suggested [5, 33, 34], in patients with pure TGA an underlying stress reaction triggered by the acute pain event is discussed [35,36,37,38]. However, TGA-like symptoms are important because TGA may extinguish important details of the patient’s recent history.…”

Section: Symptoms Of Brain Involvementmentioning

confidence: 99%

Neurological Symptoms in Aortic Dissection: A Challenge for Neurologists

2008

View full text Add to dashboard Cite

Typically, aortic dissection has to be considered in patients with acute thoracic or abdominal pain and accompanying cardiovascular symptoms. Due to these clinical symptoms, neurologists have not been involved in the routine emergency management of aortic dissection. However, transient or permanent neurological symptoms at onset of aortic dissection are not only frequent (17–40% of the patients), but often dramatic and may mask the underlying condition. Especially in pain-free dissection (which occurs in 5–15%) with predominant neurological symptoms diagnosis of aortic dissection can be difficult and delayed. Affecting the outflow of supra-aortal, spinal as well as extremity arteries leads to a variety of neurological symptoms including disturbances of central or peripheral nervous system. Thrombolysis as an emergency stroke therapy without considering aortic dissection may be life-threatening for these patients. Routine chest X-ray and being alert to physical examination findings such as hypotension, asymmetrical pulses or cardiac murmur may reduce risk of delayed diagnosis or misdiagnosis. Neurological symptoms at onset or in the postoperative course of aortic dissection are not necessarily associated with increased mortality.

show abstract

Section: Symptoms Of Brain Involvementmentioning

confidence: 99%

Neurological Symptoms in Aortic Dissection: A Challenge for Neurologists

2008

View full text Add to dashboard Cite

show abstract

“…So far, nine cases with acute ADA and amnesia have been described, as listed in the table. [1][2][3][4][5][6][7] Six of these nine patients experienced anterograde amnesia in the form of a TGA. However, in none of the previously published cases, an activity associated with increased intrathoracic pressure has been reported.…”

Section: Discussionmentioning

confidence: 99%

Anterograde Amnesia as a Manifestation of Acute Type A Aortic Dissection

et al. 2019

View full text Add to dashboard Cite

Objectives Memory impairment has been only rarely reported in association with acute aortic dissection type A. We report a patient with pure anterograde amnesia and memory impairment of contents occurring after the event, accompanying acute aortic dissection type A. Case Report A previously healthy 53-year-old Caucasian male was admitted because of sudden chest pain after having lifted a heavy object. Clinical examination and electrocardiogram showed no abnormalities. Since blood tests showed leukocytosis, anemia, and elevated D-dimer level, either pulmonary embolism or aortic dissection was suspected; therefore, computed tomography was suggested. The patient seemed disoriented to time, and neurologic investigation confirmed that the patient was disoriented to time; short time memory was severely impaired and concentration was reduced. An amnestic episode with anterograde amnesia was diagnosed. Computed tomography showed type A aortic dissection. A supracoronary replacement of the ascending aorta was performed. The patient was discharged on the 7th postoperative day. Three months postoperatively, the patient is clinically stable; however, amnesia for the interval between pain onset and cardiac surgery persists. Conclusions Transient amnesia, usually considered a benign syndrome, may be more common than generally recognized in aortic dissection. The suspicion for aortic dissection or other cardiovascular emergencies is substantiated when amnesia is associated with sudden onset of chest pain, leukocytosis, and elevated D-dimer levels. Computed tomography of the aorta with contrast medium is the imaging method of choice to confirm or exclude the diagnosis.

show abstract

“…The pathogenesis of TGA might be associated of a transient perturbation of hippocampal function and different precipitating events including a stress response, emotional state, painful experiences, temperature extremes (e.g., those produced by swimming in cold water or taking a hot bath), sexual intercourse are present in 33% to 84% of attacks [15,[17][18][19][20][21][22][23][24]. TGA has also been reported to be associated with Valsalva manoeuvre [25], bilateral vertebral artery dissection [26] and aortic dissection [27]. A case of TGA has been reported following the use of sildenafil [28] or ergotamine and dihydroergotamine [29].…”

Section: Discussionmentioning

confidence: 99%

Transient global amnesia after epiduroscopy in a failed back surgery syndrome patient: Case report

Consoletti¹,

Cotoia²,

Cinnella³

et al. 2013

Health

View full text Add to dashboard Cite

Epiduroscopy (EDS) allows diagnosis and treatment of spinal nerve root pathology by a fiberoptic device inserted percutaneously in the epidural space. Transient global amnesia syndrome (TGA) is defined by an abrupt onset of an anterograde and retrograde amnesia that lasts up to 24 h, although mild subclinical neuropsychological deficits, with concomitant vegetative symptoms, can last for days after the episode. To our knowledge no cases of TGA in association with EDS have been recognized. We present a case of a 54-year-old man who was admitted for EDS, having experienced two times the failed surgery for spinal and left leg pain. During the EDS, 10 ml of non-ionic contrast media (CM) was injected to confirm the inside lesions. The epidural adhesions were gently broken down and drugs were injected around any inflamed nerve roots. Immediately after EDS, the patient experienced a TGA with loss of memory for the recent procedure and an impaired ability to retain new information. There were no signs of confusion or altered conscious level or seizure activities and neurological examination was normal. At 24 h a cranial computerized tomography (cCT) without CM showed "abnormal contrast enhancement at subarachnoid liquoral spaces levels", then at 72 h cCT control was normal. The patient was discharged on the seventh day with perioperative lacunar amnesia persisting at this time. Herein, we sought a possible relationship between neurotoxic effect of CM and TGA in a patient emotionally stressed, even if the CM dose was given as a normal clinical range.

show abstract

Transient global amnesia caused by painless aortic dissection

Cited by 20 publications

References 5 publications

Neurological Symptoms in Aortic Dissection: A Challenge for Neurologists

Neurological Symptoms in Aortic Dissection: A Challenge for Neurologists

Anterograde Amnesia as a Manifestation of Acute Type A Aortic Dissection

Transient global amnesia after epiduroscopy in a failed back surgery syndrome patient: Case report

Contact Info

Product

Resources

About