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Abstract: Amnesia includes both prograde amnesia, in which the ability to learn or form new memories by acquiring some form of new information is impaired, and retrograde amnesia, in which the ability to reproduce or recall information stored before the illness is impaired. Memory is an extremely complex function that involves stages of recording, storage and extraction. This case is about persistent amnesia due to a large cerebral infarction on the medial aspect of the temporal lobe. In this paper, the patient had persistent memory loss, which was considered to be caused by massive cerebral infarction, and recovered well with treatment such as improved circulation, cerebral protection, and dehydration.
[Basic information] Male, 56 years old
Type of disease】Amnesia
Hospital】The Second Hospital of Harbin Medical University
Date of consultation】February 2022
Treatment plan】Medication (hemosiderin injection + hemosiderin injection + piracetam tablets + aspirin tablets + clopidogrel sulfate tablets + cerebroprotein hydrolysate tablets)
Treatment Period】7 days of hospitalization
Treatment effect】The condition gradually improved and the symptoms of persistent memory loss were relieved
I. Initial interview
Two days before admission to the hospital, the patient showed persistent memory loss without obvious causes, manifested by the inability to remember what he had eaten, the inability to remember where he had been before, memory loss of his own telephone number, remembering only a few numbers, often misreporting, no memory loss of his name, residence, friends’ names, no limb numbness, upper limbs can be lifted, no headache, no dizziness, nausea and vomiting, no convulsions, no urinary or fecal The patient’s family was very anxious to find our clinic and informed him that he needed to be admitted to the hospital. The family was very cooperative, so the patient was immediately admitted to the hospital and immediately underwent magnetic resonance examination of the head and subsequent laboratory tests such as routine blood collection.
II. Treatment process
The patient’s consciousness was clear, his speech was acceptable, his pupils were rounded bilaterally with a diameter of about 3.0 mm, his near memory was impaired, his distant memory was slightly changed, his right limb strength was grade 3, his right muscle tone was increased, his right lower limb pathology was positive, his head MRI showed multiple lacunar cerebral infarcts, and his head DWI showed large cerebral infarcts in the medial temporal lobe. The patient was then given vascularizing drugs, i.e. hemosiderin injection and sparing blood injection, piracetam tablets to nourish brain nerves, dual anti (aspirin tablets + clopidogrel hydrogen sulfate tablets), cerebral protein hydrolysate tablets to improve brain metabolism to improve memory, and overall drug hospitalization for observation and treatment for 7 days.
III. Treatment effect
After 7 days of treatment in our hospital, the patient’s condition gradually improved, and the symptoms of memory loss were relieved. At the time of discharge, the patient could already remember most things, but could not remember some fine details, after all, the infarct area was large, and the symptoms of limb weakness were also relieved, and the muscle strength of the right limb reached grade 4 at the time of discharge.
IV. Notes
I was very pleased to see the patient gradually improving and being discharged from the hospital. I told the patient that he should still control the risk factors of cerebrovascular disease in his life, maintain healthy eating habits, such as low salt and low fat diet, drink more water, 2000-3000ml is recommended daily, avoid staying up late, actively control blood pressure, blood sugar and blood lipids, exercise appropriately, and eat less spicy and stimulating food. And regularly go to the hospital to review the cranial magnetic resonance, bilateral carotid ultrasound to clarify their condition and the recovery of the disease. If there are uncomfortable symptoms, you must go to the hospital for treatment in time.
V. Personal insight
Persistent amnesia due to large cerebral infarction in the medial temporal lobe needs to be distinguished from amnesia due to the following causes: firstly, post-traumatic amnesia, where the severity of trauma is related to the degree of confusion and retrograde amnesia, followed by amnesia due to ischemia or hypoxia, such as cardiac arrest or CO poisoning, which is prone to occur in cases where coma lasts for at least 12 hours. Finally, there is psychogenic amnesia, where a prior history of psychosis should be confirmed and symptoms are mainly characterized by isolated and disproportionate memory loss. In contrast, this patient had persistent amnesia due to a large cerebral infarction in the medial temporal lobe, which was thankfully effectively controlled after aggressive pharmacological treatment.