Neurological Sciences

, Volume 39, Issue 9, pp 1647–1649 | Cite as

Unilateral or bilateral punctate hippocampal hyperintensities on DW-MRI: seizures, amnesia, or both?

  • Jone Bocos-Portillo
  • Inés Escalza-Cortina
  • Marian Gómez-Beldarrain
  • Aida Rodriguez-Sainz
  • Juan Carlos Garcia-MoncoEmail author
Brief Communication


The presence of small hippocampal hyperintense lesions on diffusion-weighted (DW) MRI can respond to different etiologies and represents a challenge where clinical judgment is imperative, since therapeutic approach may be quite different.

We here report three patients with similar neuroradiological findings, i.e., hyperintense punctate hippocampal lesions on diffusion-weighted MRI sequences, yet of different origin. The first one presented with isolated amnesia (transient global amnesia), the second one with amnesia and seizures, and the third one with seizures.

Thus, hippocampal punctate lesions appear after transient global amnesia, but the same pattern may be present after seizures, either focal-onset or generalized seizures. This peculiar radiological MRI pattern could indicate a pathogenic link between transient global amnesia (TGA) and seizures which should be further studied.


Hippocampus Seizures Transient global amnesia Punctate lesions Magnetic resonance imaging 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


This is a descriptive, observational study in which the identity of the patients is completely protected; therefore, no informed consent is required.


  1. 1.
    Bhattacharyya S, Gholipour T, Colorado RA, Klein JP (2017) Bilateral hippocampal restricted diffusion: same picture many causes. J Neuroimaging 27(3):300–305. CrossRefPubMedGoogle Scholar
  2. 2.
    Szabo K, Forster A, Jager T, Kern R, Griebe M, Hennerici MG, Gass A (2009) Hippocampal lesion patterns in acute posterior cerebral artery stroke: clinical and MRI findings. Stroke 40(6):2042–2045. CrossRefPubMedGoogle Scholar
  3. 3.
    Forster A, Griebe M, Gass A, Kern R, Hennerici MG, Szabo K (2012) Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus. Cerebrovasc Dis 33(2):104–115. CrossRefPubMedGoogle Scholar
  4. 4.
    Cuello Oderiz C, Minarro D, Dardik D, Fernandez MC (2015) Teaching NeuroImages: hippocampal foci of restricted diffusion in transient global amnesia. Neurology 85(20):e145. CrossRefPubMedGoogle Scholar
  5. 5.
    Wilkinson T, Geranmayeh F, Dassan P, Janssen JC (2013) Neuroimaging in transient global amnesia. Pract Neurol 13(1):56–57. CrossRefPubMedGoogle Scholar
  6. 6.
    Kim JA, Chung JI, Yoon PH, Kim DI, Chung TS, Kim EJ, Jeong EK (2001) Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: periictal diffusion-weighted imaging. AJNR Am J Neuroradiol 22(6):1149–1160PubMedGoogle Scholar
  7. 7.
    Marinkovic S, Milisavljevic M, Puskas L (1992) Microvascular anatomy of the hippocampal formation. Surg Neurol 37(5):339–349CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Departmenf of NeurologyHospital de Galdakao-UsansoloGaldakaoSpain

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