Bilateralni hipokampalni infarkt i amnezija

Smiljana Kostić; Viktor Pasovski; Željko Krsmanović; Željko Bošković; Dejan Kostić; Aleksandar Jovanovski; Jasmina Jović - Stošić

doi:10.2298/5816

Smiljana Kostić Clinic for Neurology, Military Medical Academy, Belgrade Serbia
Viktor Pasovski Clinic for Neurology, Military Medical Academy, Belgrade Serbia
Željko Krsmanović Clinic for Neurology, Military Medical Academy, Belgrade Serbia
Željko Bošković Clinic for Neurology, Military Medical Academy, Belgrade Serbia
Dejan Kostić Institute for Radiology, Military Medical Academy, Belgrade Serbia
Aleksandar Jovanovski Vojnomedicinska akademija,Institut za radiologiju
Jasmina Jović - Stošić National Poison Control Centre, Military Medical Academy, Belgrade Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

DOI: https://doi.org/10.2298/5816

Sažetak

Uvod. Hipokampus zajedno sa ostalim strukturama medijalnog temporalnog režnja ima značajnu ulogu u procesu učenja i konsolidacije pamćenja. Bilateralne lezije hipokampusa dovode do perzistentne anterogradne amnezije dok unilateralno oštećenje rezultuje blažim, sadržajno određenim oblicima amnezije. Hipokampus može biti pogođen akutnim i hroničnim patološkim procesom u sklopu širokog spektra neuroloških oboljenja. Prikaz bolesnika. Bolesnica, stara 61 godinu, sa istorijom dugogodišnje arterijske hipertenzije, intolerancije glukoze, hiperholesterolemije i depresije, hospitalizovana je zbog akutne anterogradne amnezije koja je dovela do ponavljanog prekomenrog konzumiranja lekova. Daljim ispitivanjima koja su uključila laboratorijska ispitivanja, elektroencefalografiju, doplersonografiju intra- i ekstrakranijalnih krvnih sudova, neurovizuelizacione tehnike [multislajsnu kompjuterizovanu tomografiju (MSCT) i magnetsku rezonancu (MR) mozga] ustanovljena je bilateralna ishemija hipokampusa različitog vremena nastanka. Kognitivno i neuropsihološko ocenjivanje pokazalo je izolovano teško oštećenje epizodičnog pamćenja, sa nemogućnošću pamćenja novih informacija koje se održavalo i nakon tromesečne kontrole. Predpostavljeni mehanizam nastanka ishemije u ovom slučaju mogao bi biti arterijsko-arterijski embolizam. Zaključak. Iako je ishemički moždani udar jedna od najčešćih neuroloških bolesti, ishemički infarkt hipokampusa je redak, posebno izolovana bilateralna prezentacija sa kliničkom slikom teškog amnestičkog sindroma. Blagovremeno prepoznavanje i savremeni terapijski pristup bi mogli uticati povoljno na oporavak teškog neurološkog, kognitivnog deficita. Izdvaja se sugestija da se kod bolesnice sa ovakvom kliničkom slikom akutne anterogradne amnezije i vaskularnim faktorima rizika odmah pri prijemu uradi MSCT pregled mozga, po mogućstvu za CT perfuzijom i angiografijom.

Biografije autora

Smiljana Kostić, Clinic for Neurology, Military Medical Academy, Belgrade Serbia

Klinika za neurologiju VMA, neurolog specijlista

Viktor Pasovski, Clinic for Neurology, Military Medical Academy, Belgrade Serbia

Klinika za neurologiju VMA, lekar na specijalizaciji

Željko Krsmanović, Clinic for Neurology, Military Medical Academy, Belgrade Serbia

Klinika za neurologiju VMA, neurolog specijalista

Željko Bošković, Clinic for Neurology, Military Medical Academy, Belgrade Serbia

Klinika za neurologiju VMA, neurolog specijalista

Dejan Kostić, Institute for Radiology, Military Medical Academy, Belgrade Serbia

Institut za radiologiju VMA, radiolog specijalista

Aleksandar Jovanovski, Vojnomedicinska akademija,Institut za radiologiju

Institut za radiologiju VMA, radiolog specijalista

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