Transient Global Amnesia Associated with Acute Intracerebral Hemorrhage at the Cingulate Gyrus

other neurological symptoms such as headache, dizziness or focal weakness. There was no history of hypertension, diabetes, transient ischemic attacks, stroke, epilepsy, migraine, psychiatric illness, head trauma or alcohol abuse. On examination, the patient was alert, with a blood pressure of 130/80 mm Hg, a regular heart beat of 75 beats/min and a temperature of 36.7 ° C. Physical examination demonstrated no pathologic findings. On cognitive function evaluation, comprehension was intact and the patient was fully conscious; however, he immediately forgot what was heard and continued repetitive questioning regarding what he was doing here. Except for memory deficits, the other cognitive profiles, which included attention, praxis, language and frontal function, were normal. The patient’s amnesia and repetitive questioning gradually resolved after 6 h. The next morning, the patient was oriented and had recovered anterograde and recent retrograde memory, but not memory during the attack. Laboratory studies including complete blood cell and platelet count, erythrocyte sedimentation rate, blood electrolytes, creatinine, liver enzymes, cholesterol, triglycerides, prothrombin and partial thromboplastin time, antithrombin III-protein C and protein S activity were all normal. In addition, autoantibody screens were also normal. Neither the electrocardiogram from a 24-hour Holter monitor nor transthoracic echocardiography revealed any cardiac abnormalities. The waking surface EEG during the episode was normal. Brain Dear Sir, Transient global amnesia (TGA) is a benign neurological syndrome characterized by temporary loss of anterograde and recent retrograde memory with preserved consciousness and self-awareness; it is usually accompanied by repetitive questioning and temporal disorientation for a limited period of time [1] . In the majority of TGA cases, no cause can be identified; structural imaging is invariably normal and CSF studies are generally not performed. EEGs that have been performed during an episode have been reported to demonstrate no epileptiform abnormalities [2] . Several different causes for this syndrome have been proposed, including ischemia, migraine, epileptic seizure, venous congestion and psychological disturbances; however, there remains no consensus on the etiology [3] . Moreover, TGA associated with intracerebral hemorrhage has rarely been reported. The patient described here presented with transient amnesia resulting from a left cingulate lesion. This is of particular interest because these findings suggest that activity in the cingulate gyrus and its outflow pathways may lead to TGA.