Abstract
Few studies have investigated transient global amnesia (TGA) in the context of a concussion and the concussion sequelae following TGA. Here we review the case of a 43-year-old male with onset of transient global anterograde and retrograde amnesia 22 days after a sustained concussion. The patient's head CT, MRI of brain, and EEG were reported normal, and the patient regained full cognitive function 8 h after the TGA episode, with no recollection of the conspiring events. Following the TGA episode, the patient experienced notable worsening of concussive symptoms, including headache, head pressure, anxiety, neck pain, feeling slowed down, fogginess, not feeling right, difficulty remembering, and fatigue. The patient remained symptomatic for 32 days after the TGA episode. We suggest that a lingering window of post-concussion cerebral vulnerability, which may extend beyond clinical recovery, could lead to increased susceptibility to acute cognitive deficits, such as TGA.
Highlights
BackgroundTransient global amnesia (TGA) is a rare clinical syndrome, which affects predominantly patients aged 50–70 years, characterized by an acute onset of anterograde and retrograde amnesia, often accompanied by repetitive questioning, lasting up to 24 h, and not associated with other neurological deficits
While its exact pathogenesis remains unknown, transient global amnesia (TGA) has been associated with both physical and emotional precipitating events, such as physical exertion, changes in body temperature, and anxiety—each present in the current case [2, 3]. While these events have commonly been implicated as risk factors for TGA [1,2,3], there have only been a handful of TGA episodes precipitated by mild traumatic brain injury reported in the literature, all predating the 2000s and occurring in younger patients [4,5,6,7]
Previous literature excludes patients with recent head trauma, as per the Hodges and Warlow [8] diagnostic criteria for TGA, there is not a strong consensus for the temporal definition of “recent,” which is critical as the patient presented here was diagnosed with a concussion 22 days prior to the TGA episode
Summary
Transient global amnesia (TGA) is a rare clinical syndrome, which affects predominantly patients aged 50–70 years, characterized by an acute onset of anterograde and retrograde amnesia, often accompanied by repetitive questioning, lasting up to 24 h, and not associated with other neurological deficits. Other symptoms reported to have developed in the days after TGA were all mild in severity and included neck pain, feeling slowed down, fogginess, not feeling right, difficulty remembering (described as a vague sense of slower retrieval of memories rather than the short-term memory deficit seen in TGA), and fatigue. Of note, these symptoms were self-reported on a concussion symptom evaluation checklist and not representative of impaired cognition. He was deemed fully recovered from his concussion with no persistent symptoms 32 days after the TGA episode (54 days after initial head injury)
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