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KMID : 0385920140250060696
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Journal of the Korean Society of Emergency Medicine
2014 Volume.25 No. 6 p.696 ~ p.702
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Clinical Characteristics of 372 Cases of Transient Global Amnesia in the Emergency Department: A Single Center Study
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Shin Yo-Sep
Ahn Shin
Lim Kyoung-Soo
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Abstract
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Purpose: Transient global amnesia (TGA) is characterizedby abrupt onset of antegrade amnesia usually seekingemergency care. We analyzed the clinical characteristics ofTGA patients and the significance of diffusion weightedimaging (DWI) in the diagnosis of TGA.
Methods: Retrospective analysis was performed usingelectronic medical records of patients diagnosed as TGA inthe emergency departments from January 2003 toDecember 2013. The patient’s clinical characteristics andprecipitants were analyzed, and detection rate of hippocampallesion was compared according to the time to DWI aftersymptom onset (< 6 h, 6~12 h, 12~24 h, and >24 h).
Results: Of 372 consecutive TGA patients studied, 27 hada positive DWI lesion in hippocampus. Demographics andvascular risk profile were not significantly different betweenthose in DWI (+) and DWI (-), and neither was duration ofamnesia (p=0.076). However, the median time interval toDWI was significantly longer in DWI (+) than DWI (-) [7.5(5.5~15.0) h vs. 6.0 (3.5~9.0) h, p=0.011]. In addition, thedetection rate of hippocampal lesion increased with the timeinterval [0-6 h (4.1%), 6~12 h (10.7%), 12~24 h (11.1%),and >24 h (16.1%), p=0.004].
Conclusion: Positive hippocampal lesion on DWI can confirmthe diagnosis of TGA; however, difference in lesiondetectability in regard to time interval from symptom onsetto DWI should be considered in diagnosis of TGA with DWI.
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KEYWORD
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Transient global amnesia, Diffusion magnetic resonance imaging, Emergency departments, Hippocampus
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