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Diffusion‐weighted MRI in transient global amnesia: Elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients
Author(s) -
Strupp Michael,
Brüning Roland,
Wu Ren Hua,
Deimling Michael,
Reiser Maximilian,
Brandt Thomas
Publication year - 1998
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410430206
Subject(s) - transient global amnesia , magnetic resonance imaging , temporal lobe , nuclear medicine , medicine , diffusion mri , positron emission tomography , nuclear magnetic resonance , coronal plane , radiology , epilepsy , amnesia , physics , psychiatry
Prompted by the findings of previous studies with positron emission tomography and single photon emission computed tomography, which demonstrated hypoperfusion or hyperperfusion in the left temporal lobe in isolated patients with transient global amnesia (TGA), we compared the sensitivity of diffusion‐weighted (DW) magnetic resonance imaging (MRI) with that of conventional T1‐ and T2‐weighted MRI in patients with TGA. Ten patients with the typical syndrome of a pure TGA were included in the study. For all patients, a coronal DW sequence, a steady‐state free precession (SSFP) sequence, and conventional T1‐ and T2‐weighted turbo spin‐echo sequences were obtained. Seven of the 10 patients had elevated signal intensity in the left hippocampal region on DW MRI; moreover, 3 of these 7 patients exhibited bilateral signal abnormality in this sequence. All conventional T1‐ and T2‐ weighted images as well as all follow‐up studies were normal. The signal elevation in DW MRI correlates with a decrease in the interstitial space and with cellular edema in the temporal lobe during TGA. The underlying pathomechanism causing this cellular edema cannot be clearly outlined using DW MRI. Our data are, however, compatible with spreading depression. This is the first study to show that DW MRI is a sensitive MRI method for evaluating TGA, especially in the early stage of the disease.