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
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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.
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
Marinkovic S, Milisavljevic M, Puskas L (1992) Microvascular anatomy of the hippocampal formation. Surg Neurol 37(5):339–349CrossRefPubMedGoogle Scholar