短暂性完全遗忘综合征

短暂性完全遗忘综合征是一种突然发生的、以短暂性近事遗忘为主要特点的临床综合征。多在 2 4小时内完全恢复。本文就其临床特点、病因和发病机制、辅助检查、治疗和预后作了简要介绍。     

短暂性完全遗忘综合征

短暂性完全遗忘(Transient Global Amnesia,TGA)是一种临床综合征。1956年由Bender首次报道一例以一过性单纯遗忘发作为特征的病例,称之为伴有遗忘的精神错乱,其后国外相继有所报道,1958年由Fisher和Adam正式命名为TGA,它以突然发生的一过性逆行性遗忘为主要特征,常在24小时内缓解。近年来国内外均认为TGA是一种独立的疾病,其发病率也随着年龄的增加而增加。现将作者诊治的9例患者报告如下:     

短暂性全面性遗忘的临床诊治分析

目的:总结分析短暂性全面性遗忘的危险因素、发病机制、临床表现、辅助检查及治疗方法,以其加深对该病的认识。方法:收集短暂性全面性遗忘患者15例的临床资料进行分析,并结合文献回顾。结果:15例患者中女性占66.7%;年龄56～85岁,平均年龄67.1岁;3例并发焦虑、抑郁。15例均以突发记忆丧失为主诉,同时伴随头晕、头痛等症状;3例发病前有情绪激动诱因;4例并发心率失常,脑电图均无异常尖波、棘波等;5例头颅CTA提示大脑后动脉存在变异或狭窄。全组头颅核磁均未检测到DWI异常信号。治疗上均给予抗血小板聚集、改善循环等治疗;2例复发。结论:短暂性全面性遗忘主要表现新记忆的形成障碍,是一种临床过程良性的疾病,血管因素、低灌注、情绪应激均参与该病的发病过程。     

短暂性脑缺血发作的临床研究

1引言 短暂性脑缺血发作(transient ischemic attacks,TIA)被认为是脑血管病的危险信号,越来越受到重视,其临床特征是是阵发性、短暂性、反复发作性、可逆性的局部或全脑急性循环障碍而出现局部神经症状,可于短时间内不留任何痕迹而恢复正常.     

短暂性完全遗忘综合征3例报告

短暂性完全遗忘（Ｔｒａｎｓｉｅｎｔｇｌｏｂａｌａｍｎｅｓｉａ,ＴＧＡ）是一种临床综合征,表现为短暂性突然记忆障碍,一般不超过２４小时。自５０年代发现该病以来,国外已有近千例报道,但国内报道较少。我们收治３例病人,现就其病因、发病机理、临床特点、诊断及...     

癫痫误诊为短暂性脑缺血发作1例临床分析

患者,女,71岁,主因发作性意识恍惚10天,于2010年5月31日以短暂性脑缺血发作（TIA）收入院。患者于入院前10天因精神受刺激后出现发作性意识恍惚、反应迟钝、表情呆滞、言语和动作迟缓,不认家人,不认熟悉的汉字及数字,每次持续约30分钟至2小时,可自行缓解,发病时测血糖、血压均在正常范围,无头痛,无肢体活动障碍,无肢体抽搐。     

青少年急性短暂性精神障碍合并癫痫1例

目的 探讨治疗青少年急性短暂性精神障碍合并癫痫的临床思维及诊治方法.方法 回顾分析1例急性短暂性精神障碍合并癫痫青少年患者的临床资料.结果 男性患者,年龄13岁零两个月,因两次急起言行紊乱就诊,头颅MRI及脑电图未见明显异常,先后诊断急性应激障碍及急性短暂性精神障碍,先后予奥氮平、帕利哌酮抗精神病药物治疗,期间患者再次...     

短暂性全面遗忘综合征2例报道

短暂性全面遗忘(transient global amnesia,TGA)是易发生于中老年人的一种急性遗忘综合征,表现为患者短期内突然不能接受新的信息而保留远期记忆,症状常在24 h内缓解.1956年Bender首次报道,称为伴有遗忘的精神错乱;1958年由Fisher和Adam正式命名为TGA.其后国外有很多这样的病例报道[1-2].据报道,美国的发病率为5.2/105,50岁以上人群发病率为23.5/105.现将我科2007年收治的2例病例报道如下.     

丛集性短暂性脑缺血发作

丛集性短暂性脑缺血发作(Cluster transient ischemic attack)CTIA是指在一段时间内频繁发作的TLA,包括以下三种情况:①“每日一次型”连续数日发作TIA,每天仅有1次;②24小时内有多次TIA发生,又被称为“枪击样”发作(gunshot);③连续数天(至少2天)发生“枪击样”发作,又被称之为“多发枪击样”发作(multiple-gunshot)。本文报告CTIA25例患者的临床表现和近期追踪结果。     

短暂性完全遗忘综合征53例国内文献回顾

短暂性完全遗忘综合征 (ＴＧＡ)是易发生于中老年人群的一种急性遗忘综合征。自 5 0年代发现该病以来 ,国外已有 10 0 0余例报道 ,但国内报道较少。我们综合国内近年来公开发表的5 3例ＴＧＡ患者的资料 ,现报告如下。1　临床资料1.1　资料来源　本文通过ＣＢＭ检索了国内自首例报道ＴＧＡ截止到 1999年底所有公开发表的文献[1～ 4 ] 及 2 0 0 0年部分现刊 ,剔除来自同一单位或个人可能的重复报道后共得 5 3例 ,其中男 37例 ,女 16例 ,男∶女为 2 .3∶1,年龄 2 2～ 80岁 ,平均 5 6 .2岁。1.2　临床表现　均突然发病 ,持续 10分钟到数小时 ,一…     

短暂性全面遗忘症20例脑电图分析

目的探讨短暂性全面遗忘症的脑电图表现。方法比较短暂性全面遗忘症患者与正常人的脑电图表现,对其病理机制及治疗进行探讨。结果短暂性全面遗忘症患者的脑电图异常率明显高于对照组,两组比较,差异显著(P<0.05),不同年龄短暂性全面遗忘症患者脑电图异常差异无显著性。结论短暂性全面遗忘症患者的脑电图有明显异常,可根据其异常对患者进行个体化治疗,脑电图表现对探索其病因及病理机制有一定的指导意义。     

短暂性脑缺血发作对脑缺血耐受影响的临床研究

目的探讨短暂性脑缺血发作（TIA）在脑缺血耐受方面的临床意义。方法选择105例TIA后发生脑梗死的患者为TIA组，并选择110例无TIA史的脑梗死患者作对照组。结果TIA组和对照组在脑梗死体积（7．68mm^3 vs 11．2mm^3）、治疗前与治疗后15d、30d的中国卒中量表评分方面存在统计学差异[（21±3）vs（26±5）；（14±2）vs（20±2）；（7±3）vs（16±3）]P〈0．05。结论TIA后发生脑梗死对减轻脑细胞损伤有一定临床意义。     

A case of transient global amnesia with hippocampal infarction due to infective endocarditis

Transient global amnesia (TGA) is an uncommon disease characterized by sudden onset anterograde amnesia that typically improves within 24 hours. A 35-year-old woman presented with complete disruption of memory that had started on the previous day. She had fever and heart murmur and was diagnosed as having infective endocarditis with Staphylococcus lugdunensis, a coagulase-negative staphylococcus. Septic embolizations were found in the spleen and kidney on CT scan. The patient underwent aortic valve replacement. MRI susceptibility-weighted imaging showed a dotted low intensity area in the right hippocampus. Recently, etiology of TGA is reported to be related to hippocampal disorder. We report a rare case of TGA with hippocampal infarction due to septic embolism from infective endocarditis.     

短暂性脑缺血发作频率与临床特征的相关研究

目的探讨短暂性脑缺血发作(TIA)发作频率与临床特征的关系。方法从南京卒中注册数据库中选择符合研究方案的TIA患者172例,按照发作频率分为单发性TIA和多发性TIA(发作次数≥2),多发性TIA按照每次发作症状是否相同分为刻板性TIA和变异性TIA,对不同发作频率TIA的临床特征进行分析。结果单发性TIA和多发性TIA比较,房颤、肢体无力多见于单发性TIA(P＜0．05),颅内外大动脉病变多见于多发性TIA(P＜0．05)；刻板性TIA和变异性TIA比较,颅内外大动脉病变多见于刻板性TIA(P＜0．05)。结论颅内外大动脉病变常见于多发性TIA和刻板性TIA,房颤、肢休无力多见于单发性TIA。对TIA患者应根据发作频率和症状不同进行相应的病因检查。     

阻塞性睡眠呼吸暂停低通气综合征与短暂性脑缺血发作关系的病例对照研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与短暂性脑缺血发作（TIA）的关系。方法对86例TIA患者和性别、年龄相匹配的查体者按1：1配成,使用多导睡眠检测仪检测,同时进行TIA危险因素和OSAHS症状问卷,完成Epworth嗜睡量表（ESS）,检测血压,体质量,身高,清晨空腹血糖,血纤维蛋白原。结果睡眠呼吸暂停低通气指数（AHI）在TIA组和对照组无显著性差异,血纤维蛋白原、高血压病史、高胆固醇血症、吸烟史、心肌梗死病史在TIA组中显著高于对照组。结论 OSAHS不是TIA的危险因素。     

The link between reversible cerebral vasoconstriction syndrome and transient global amnesia

Reversible cerebral vasoconstriction syndrome (RCVS) and transient global amnesia (TGA) are acute and self-limiting intra-cerebral conditions. Although previously studied as independent phenomena, there are increasing reports of co-occurrence of these two pathologies. We report a 55-year-old male who presented to the hospital with recurrent thunderclap headaches over the course of 1 week with sudden onset of anterograde memory loss. His medications included a selective serotonin reuptake inhibitor and intermittent use of pseudoephedrine. On examination he was amnestic to recent events and notably perseverating. Magnetic resonance imaging of the brain without contrast showed a small, punctate focus of restricted diffusion in the left hippocampus. He was diagnosed with TGA based on his clinical presentation. His headaches and amnesia resolved over the next 12 h throughout the course of his stay with acetaminophen and oral verapamil and he was discharged. Repeat computed tomography angiogram at 2 weeks revealed diffuse and segmental narrowing of the anterior and posterior intracranial circulation, which resolved on follow-up imaging at 3 months, confirming RCVS. The acute and reversible nature of these conditions and increasing reports of co-occurrence suggests a common pathophysiologic link. We review the literature highlighting similar cases and the presumed pathophysiology.     

短暂性脑缺血对急性脑梗死面积及近期预后的影响

目的探讨短暂性脑缺血 (TIA)发作与其引发的急性脑梗死的类型、面积及近期预后的关系。方法根据 12 5例急性脑梗死患者发病前 3日内有无TIA分为A组和B组 ,并对两组梗死类型、临床特点及近期预后进行比较。结果有TIA组多为腔隙性梗死 ,梗死面积小 ,与无TIA组比较 ,差异有显著性意义 (P <0 .0 5 ) ;其舒张压、甘油三酯、低密度脂蛋白、血糖水平亦低 ,与无TIA组比较 ,差异有显著性意义 (P <0 .0 5或P <0 .0 1)。结论TIA发作可以提高脑细胞对严重缺血的耐受性和脑循环的储备力 ,限制梗死范围的延展 ,缩小梗死范围 ,进而改善脑梗死患者的近期预后。     

"Forgettable" sex: a case of transient global amnesia presenting to the emergency department

Background: Transient global amnesia is characterized by the sudden development of dense anterograde amnesia, without alteration in level of consciousness and in the absence of focal neurologic deficits or seizure activity. Various precipitating causes have been reported in the medical literature. Objective: To present a literature-guided approach to the diagnosis and management of transient global amnesia in the Emergency Department (ED). Case Report: We report the case of a 54-year-old woman who presented to the ED with an episode of acute memory loss. Conclusions: Although rare, transient global amnesia may present in a dramatic fashion. The occurrence of a distinct precipitating event and repetitive questioning seem to be key features in making the diagnosis. Important differential considerations include transient ischemic attack, seizure, and subarachnoid hemorrhage. Brain imaging and specialty consultation are reserved primarily for patients with unclear circumstances, altered level of consciousness, focal neurologic findings, and persistent (or very brief) amnestic symptoms. Brain imaging may, however, relieve anxiety about more dangerous causes of the event.     

Transient global amnesia: cerebral venous outflow impairment-insight from the abnormal flow patterns of the internal jugular vein

Cerebral venous reflux is found frequently in transient global amnesia (TGA) patients. The cerebral venous reflux mostly results from left brachiocephalic venous obstruction, and the level of reflux depends on different respiratory status. For further understanding of the role of venous outflow impairment in the pathogenesis of TGA, we used color duplex sonography to reveal the flow patterns in the internal jugular vein (IJV) and its branches (JB) under different respiratory conditions. We compared the frequency of abnormal venous flow of IJV and/or JB on color duplex sonography between 17 TGA patients and 17 age- and gender-matched normal individuals both at rest (regular breathing) and at deep inspiration. Further, these venous-flow abnormalities in IJV and JB were well described. Cranial 3-D time-of-flight magnetic resonance arteriography (MRA) were performed in all patients three to seven days after their TGA attacks and in all normal individuals to analyze the abnormal flow signals in the intracranial venous structures. In the result, abnormal flow-patterns in the left IJV and/or left JB during regular breathing were found more frequently in TGA patients than normal individuals (65% vs. 6%; p < 0.001). These abnormalities in TGA patients were (1) isolated reversed flow in the left JB, (2) segmental reversed flow in the left distal IJV and (3) continuous reversed flow in the left IJV and JB. The MRA study revealed that only the most severe reflux in the IJV causes intracranial venous reflux; six were in the group of continuous reversed flow in left IJV and one was in the group of segmental reversed flow in left distal IJV. These findings suggest that TGA might be one of the clinical manifestations of the "cerebral-type intermittent venous claudication," which stems from cerebral venous outflow impairment, insufficient venous collaterals and specific precipitating factors.     

纤溶酶与小剂量尿激酶治疗短暂性脑缺血发作中的临床对比分析

目的对比观察纤溶酶与小剂量尿激酶治疗短暂性脑缺血发作中的临床效果。方法选取2011年10月至2013年10月诊治的短暂性脑缺血发作患者109例,根据治疗方法不同分为两组,54例患者采用小剂量尿激酶治疗为对照组,55例患者采用纤溶酶治疗为观察组。比较两组患者短暂性脑缺血发作的停止时间、相关指标的改变情况[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)]、治疗效果、不良反应情况。结果治疗后两组患者TT、PT、APTT均有不同程度的升高,而Fib呈现出不同程度的下降;组间治疗后比较,观察组患者TT、PT均明显低于对照组,Fib明显高于对照组,差异有统计学意义(P0.05),但APTT比较差异无显著性(P0.05)。观察组短暂性脑缺血发作停止时间明显小于对照组(P0.05)。观察组患者总有效率98.2%稍高于对照组的96.3%,但差异无统计学意义(P0.05)。观察组患者不良反应发生率1.8%明显低于对照组的14.8%,差异有显著性(P0.05)。结论纤溶酶与小剂量尿激酶均是治疗短暂性脑缺血发作的有效药物,但纤溶酶起效更快,不良反应更少,安全性更高。