![]() The patient regained full cognitive function after 8 h, with no recollection of the episode. Head CT and MRI of the brain (whole-brain T1-weighted, T2-weighted, diffusion-weighted, and susceptibility-weighted sequences) were performed ~3 h after admission, with neuroimaging and EEG all reported as normal. On exam, he was alert, oriented to person, and able to recognize his wife, but could not name the president, year, or identify his surroundings. On the day of the TGA episode, he presented to the ER with tremors, anxiety, and anterograde and retrograde amnesia characterized by repetitive questioning. The TGA episode occurred immediately after a cold shower, which was preceded by a swim in a cold pool, physical activity with use of an inversion board, and television viewing, respectively. ![]() The post-concussion anxiety is notable given reports in literature that cite the association of psychological and physiological stress preceding TGA ( 2, 3). On the day of the TGA episode, the patient was asymptomatic except for a lingering concussion symptom of heightened anxiety. The patient had no prior personal or family history of head injury, headache, migraine, anxiety, or depression. One week post-injury, he resumed “strenuous exercise” without exacerbation of symptoms. He returned to a normal work routine 2 days post-injury and over the next week reported improvement in fogginess but heightened anxiety. He immediately reported feeling “shaken up” and “foggy,” and experienced disrupted sleep the night of the injury. ![]() The patient sought out the ski patrol and medical personnel at the ski lodge. In regard to the concussive incident, the patient sustained trauma to the front left side of his head while skiing and experienced no loss of consciousness or amnesia. Case PresentationĪ 43-year-old left-handed male working in finance presented to the emergency room (ER) with transient global anterograde and retrograde amnesia 22 days after sustaining a concussion. We present a case report of a 43-year-old male with TGA following mild traumatic brain injury (mTBI), with evidence supporting the role of mTBI as a precipitating event facilitating the pathophysiological cascade of TGA. Furthermore, few studies have investigated TGA in the context of concussion and the clinical sequelae following TGA. Although clinical characteristics of TGA have been studied for over 50 years, true etiology remains unknown. Proposed mechanisms include vascular (e.g., venous flow disturbances or focal arterial ischemia), epileptic, hypoxic, or migraine-related pathogenesis ( 1). The annual incidence of TGA is 3.4–10.4 per 100,000 people ( 1). 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. 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. The patient remained symptomatic for 32 days after the TGA episode. 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'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. ![]() 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.
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