[Amnesic syndrome following lesion of the fornix or does reversible Korsakow's syndrome exist?].
The 53-year-old female patient had suffered massive subarachnoid bleeding due to rupture of left-localized aneurysm of the anterior communicant artery. Following the neurosurgical intervention, deterioration of consciousness related to strong vasospasm occurred. Cerebral CT examination was performed, showing a 0.5 cm ischaemic lesion of the left hippocampal fornix. Due to intensive therapy, the patient recovered gradually, however considerable short-time memory deficit and severe anterograde amnesia remained. Admission of the patient in psychiatric care 5 weeks after the operation was necessary since acute deterioration had been added to memory disturbance and anterograde amnesia. Clinical features included severe short-time memory deficit, continuous and severe anterograde amnesia, disorientation, alterations of verbal fluency and abstraction. The amnesic syndrome was probably related to the hippocampal damage, but considering the development of cognitive deficits, cerebral CT was performed again, which verified internal hydrocephalus. A ventriculo-peritoneal shunt has been implanted and the patient was re-admitted in psychiatry care because of her memory deficit, anterograde amnesia and disorientation. Thereafter, low doses of citalopram and donepezil therapy was started together with temporarily used antipsychotic medication (risperidone). Gradual, but continuous improvement of memory and cognitive function could be detected, with total recovery after one year. The deficits in long- and short-term memory, orientation and cognition were totally restored.
Szakács
Réka
R
Szegedi Tudományegyetem Altalános Orvostudományi Kar, Pszichiátriai Klinika, Szeged. szakacs@nepsy.szote.u-szeged.hu
Kálmán
János
J
Barzó
Pál
P
Sas
Katalin
K
Janka
Zoltán
Z
D020324:Amnesia, Anterograde / Q000209:etiology*; D015283:Citalopram / Q000627:therapeutic use; D000077265:Donepezil; D005260:Female; D020712:Fornix, Brain / Q000293:injuries*; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D002532:Intracranial Aneurysm / Q000150:complications*; D020915:Korsakoff Syndrome / Q000209:etiology*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D018697:Nootropic Agents / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D018967:Risperidone / Q000627:therapeutic use; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*; D020301:Vasospasm, Intracranial / Q000150:complications* / Q000209:etiology
D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D015283:Citalopram; D000077265:Donepezil; D018967:Risperidone