Recovery of anterograde amnesia in a case of craniopharyngioma.
BACKGROUND
Studies of the amnesic syndrome have indicated that telencephalic and diencephalic structures are critical components of the memory system. The exact role of the mammillary bodies (MBs) in human memory remains elusive, since few cases of selective MB damage have been reported.


OBJECTIVE
To study a case of severe anterograde amnesia due to a third-ventricle craniopharyngioma with severe MB compression.


METHODS
Case report.


METHODS
Neurosurgery clinic of an academic hospital.


METHODS
A 53-year old woman who developed severe anterograde amnesia due to a third-ventricle craniopharyngioma strongly compressing the MBs and, to a lesser extent, the right hippocampus.


METHODS
Surgical excision of the tumor and neuropsychological testing and positron emission tomography during an associative memory test before and 2 months after tumor removal. A postsurgical magnetic resonance image did not show evidence of damage to the hypothalamus, thalamus, hippocampus, or MBs.


METHODS
Changes in brain imaging data and results of neuropsychological testing.


RESULTS
After tumor removal, the patient showed a complete recovery of memory functions. Performance on the associative memory test was at chance level before surgery and dramatically improved postoperatively. Results of the preoperative positron emission tomographic study showed no activity in memory-related structures. In contrast, a significant blood flow increase occurred in the anterior thalamic nuclei postoperatively.


CONCLUSIONS
These behavioral and brain imaging data stress the importance of the MBs in this patient's amnesia. Our data further suggest that the clinical prognosis of decompressing the mammillothalamic tract is excellent, even in cases of massive compression.
Kupers
Ron C
RC
PET Center, Center for Functionally Integrative Neuroscience, Aarhus University and University Hospital, Norrebrogade 44, Building 30, DK-8000 Aarhus, Denmark. ron@pet.auh.dk
Fortin
Audrey
A
Astrup
Jens
J
Gjedde
Albert
A
Ptito
Maurice
M
D020324:Amnesia, Anterograde / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D003397:Craniopharyngioma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology*