Abstract
BackgroundCognitive disorders, such as memory disturbances, are often observed following a subarachnoid hemorrhage. We present a very rare case where rupture of a posterior cerebral artery aneurysm caused restricted damage to the hippocampus unilaterally, and caused memory disturbances.Case presentationA 56-year-old, right-handed man, with a formal education history of 16 years and company employees was admitted to our hospital because of a consciousness disturbance. He was diagnosed as having a subarachnoid hemorrhage due to a left posterior cerebral artery dissecting aneurysm, and coil embolization was performed. Subsequently, he had neither motor paresis nor sensory disturbances, but he showed disorientation, and both retrograde and anterograde amnesia. Although immediate recall and remote memory were almost intact, his recent memory was moderately impaired. Both verbal and non-verbal memories were impaired. Brain computed tomography (CT) and magnetic resonance imaging (MRI) revealed a cerebral hematoma in the left temporal lobe involving the hippocampus and parahippocampal gyrus, and single-photon emission computed tomography (SPECT) demonstrated low perfusion areas in the left medial temporal lobe.ConclusionsWe suggest that the memory impairment was caused by local tissue destruction of Papez’s circuit in the dominant hemisphere due to the cerebral hematoma.
Highlights
Cognitive disorders, such as memory disturbances, are often observed following a subarachnoid hemorrhage
We suggest that the memory impairment was caused by local tissue destruction of Papez’s circuit in the dominant hemisphere due to the cerebral hematoma
Basal forebrain amnesia due to aneurysm rupture of the anterior communicating artery was reported more than 50 years ago [1,2]
Summary
Cognitive disorders, such as memory disturbances, are often observed following a subarachnoid hemorrhage. We report a case of amnestic syndrome and formation of a hematoma inside the left temporal lobe due to a dissecting aneurysm rupture of the distal portion of posterior cerebral artery. Case presentation A 56-year-old, right-handed man, with a formal education history of 16 years and company employees (office work in an insurance company) was admitted to our hospital because of a consciousness disturbance on 3rd January, 2011. He did not have any history of medication. Subarachnoid hemorrhage due to an aneurysm rupture of the left posterior cerebral artery was diagnosed, and coil embolization was performed on the same day. As it became possible to independently manage his life by learning the use of note-taking, he was discharged after 10 weeks
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