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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1398352

Vertebral artery hypoplasia and hemodynamic impairment in transient global amnesia: A case control study

Provisionally accepted
Ralph Werner Ralph Werner 1Alexandra Ekstrom Alexandra Ekstrom 2Ingo Kureck Ingo Kureck 3,4Johannes C. Woehrle Johannes C. Woehrle 1,5*
  • 1 Department of Neurology / Stroke Unit, Katholisches Klinikum Koblenz, Koblenz, Rhineland-Palatinate, Germany
  • 2 Department of Neurology, clinical Neurophysiology and Stroke Unit, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany
  • 3 Radiologisches Institut Dr. von Essen, Koblenz, Germany, Koblenz, Germany
  • 4 Department of diagnostic and interventional Radiology, Katholisches Klinikum Koblenz, Koblenz, Rhineland-Palatinate, Germany
  • 5 Department of Neurology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

The final, formatted version of the article will be published soon.

    The aetiology of transient global amnesia (TGA) is still a matter of debate.Besides ischemia of the mesial temporal lobe including the hippocampus, migraine-like mechanisms, epileptic seizures affecting mnestic structures, or venous congestion in the (para)hippocampal area due to jugular vein insufficiency have been discussed.We assessed the diameters of the intracranial arteries of TGA patients compared to controls to identify differences that support the hypothesis of reduced hippocampal perfusion as a pivotal factor in the pathophysiology of TGA. For that purpose, we reviewed magnetic resonance imaging time of flight angiographies (TOF-MRA) that were acquired during inpatient treatment of 206 patients with acute TGA. The diameters of the vertebral artery (VA) in the V4 segment, the proximal basilar artery, and the internal carotid arteries were measured manually. We compared the findings with TOF-MRA images of an age and sex matched control group of neurological patients without known cerebrovascular pathology.In TGA patients the diameter of the right VA was significantly (p<0.01) smaller compared to controls (2.09 mm vs. 2.35 mm). There were no significant differences in the diameters of the other vessels. Only the fetal variant of the posterior cerebral artery was slightly more common in TGA.The smaller diameter (hypoplasia) of the right VA supports the hypothesis of a contribution of hemodynamic factors to the pathophysiology of TGA. The fact that hypoplasia represents a congenital condition might be the explanation why previous studies failed to find an increased rate of the classical (acquired) vascular risk factors.

    Keywords: transient global amnesia, Vertebral artery hypoplasia, magnetic resonance imaging angiography, Hemodynamics, hippocampal perfusion

    Received: 09 Mar 2024; Accepted: 17 Apr 2024.

    Copyright: © 2024 Werner, Ekstrom, Kureck and Woehrle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Johannes C. Woehrle, Department of Neurology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

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