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The amnestic syndrome of posterior cerebral artery infarction
Author(s) -
Benke Thomas,
Bodner Thomas,
Wiesen Daniel,
Karnath HansOtto
Publication year - 2022
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.15449
Subject(s) - amnesia , memory impairment , medicine , verbal memory , anterograde amnesia , episodic memory , memory disorder , neuroscience , audiology , psychology , cognitive impairment , cognitive disorder , cognition , psychiatry
Background and purpose Little is known about the character and underlying lesions of ischaemic amnesia. Episodic memory functions and brain lesions were therefore studied in 84 patients with acute ischaemic infarcts in the supply territory of the posterior cerebral artery. The aim was also to learn how the neural memory systems are organized. Methods Standard neuropsychological tests were used to assess verbal and figural memory. Patients were split into memory‐impaired and memory‐intact groups. Lesions were demarcated, normalized and anatomically labelled, using standard mapping procedures. Results Of the 84 patients more than 80% had an amnestic syndrome, mostly with combined memory impairment, less often with figural or verbal memory impairment. Amnesia in subjects with left hemispheric lesions was more frequent and more severe, with significantly lower scores on the verbal memory test. Normal performance or figural amnesia were prevalent after right hemispheric lesions. However, no amnesia subtype was strictly tied to left‐ or right‐sided brain damage. Hippocampal and thalamic lesions were common, but 30% of lesions were extrahippocampal located in the ventral occipito‐temporal cortex and long occipital white matter tracts. Most amnestic patients lacked awareness for their memory impairment. Conclusions Memory impairment is a key clinical manifestation of acute posterior cerebral artery stroke. Amnesia is more frequent and more severe after left stroke, suggesting a left hemisphere dominance of the two memory systems. Domain specific memory appears not to be strictly lateralized, since deficits in verbal and figural memory were found after lesions of both sides. Extrahippocampal lesions may also cause memory impairment.

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