住院的短暂性全身性遗忘病例回顾性分析

A. Y. Ryabchenko, A. Dolgov
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摘要

介绍。短暂性全身性遗忘症(TGA)是一种临床综合征,主要临床表现为突然发展为顺行性和逆行性遗忘症,持续时间不超过24小时,无其他全身性脑或局灶性神经症状。本研究的目的是揭示TGA综合征患者的临床表现特点和其他检查方法的数据,这些患者被怀疑是急性脑循环障碍(ACCD)的初级血管科。材料和方法。本研究纳入了16例根据Hodges和Warlow(1990)的诊断标准诊断为短暂性全面性遗忘的患者。所有患者都接受了详细的神经学和一般医学检查。进行心电图、头部多螺旋ct、超声心动图、头颈部大动脉超声双工扫描、实验室检查(脂质谱)。采用简易精神状态评定量表对认知障碍进行评定。大多数患者血压升高。短暂性全身性遗忘的主要触发因素是压力。健忘症持续时间从1.5小时到5小时不等。短期记忆严重受损。在住院的第一天和第二天,50%的患者在简短的精神状态评估量表上有正常的认知功能,但到第5 - 7天,只有12.5%的患者有异常。6例发现动脉粥样硬化超声标志物为内膜-中膜复合体增厚和血脂异常。大多数患者均有左心室肥厚的征象。TGA是一种相对罕见的疾病,也是一种研究不足的综合征。由于临床表现突发性,TGA需要与急性脑循环疾病、癫痫、急性高血压性脑病和心因性遗忘鉴别诊断。TGA患者的临床特征是有动脉高血压病史,TGA发作时血压升高。最主要的诱发因素是压力。TGA发作主要发生在当天的前半部分。大多数患者在入院时有头痛主诉。患者在发病的第一天和第二天发现的认知障碍很快恢复正常。多数患者左心室肥厚。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrospective analysis of cases of transient global amnesia admitted to the hospital
Introduction. Transient global amnesia (TGA) is a clinical syndrome, the main clinical manifestation of which is sudden development of anterograde and retrograde amnesia, lasting not more than 24 hours, without other general cerebral or focal neurological symptoms.The aim of the work was to reveal the peculiarities of clinical manifestations and data of additional methods of examination of patients with TGA syndrome referred to the primary vascular department with suspected acute cerebral circulation disorder (ACCD).Materials and methods. The study included 16 patients with transient global amnesia diagnosed according to the diagnostic criteria of Hodges and Warlow (1990). All patients underwent a detailed neurological and general medical examination. Electrocardiography, multispiral computer tomography of the head, echocardiography, ultrasound duplex scanning of the main arteries of the head and neck, laboratory examination (lipid spectrum) were performed. The Brief Mental Status Rating Scale was used to assess cognitive impairment.Results. The majority of patients had elevated blood pressure (BP). The leading trigger factor of transient global amnesia was stress. The duration of amnesia ranged from 1.5 to 5 hours. There was a significant impairment of short-term memory. On the first and second days of hospitalization, 50% of patients had normal cognitive functions on a brief mental status assessment scale, but by the 5th−7th day only 12.5 % of patients had abnormalities. Ultrasound markers of atherosclerosis in the form of intima-media complex thickening and dyslipidemia were found in 6 patients. Signs of left ventricular hypertrophy were found in the majority of patients. Discussion TGA is a relatively rare condition and an understudied syndrome. Due to its suddenness of clinical manifestation, TGA requires differential diagnostics with acute cerebral circulatory disorders, epilepsy, acute hypertensive encephalopathy and psychogenic amnesia.Conclusion. The clinical features of TGA identified in the patients were a history of arterial hypertension, elevated BP during an episode of TGA. The leading provoking factor was stress. TGA episode occurred predominantly in the first half of the day. The majority of patients had complaints of headache on admission. Cognitive disorders detected in patients on the first and second days of the disease quickly regressed to normal. Left ventricular hypertrophy was detected in most patients.
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