Hippocampal focal ischemia

Case contributed by Dr Bruno Di Muzio

Presentation

Patient presented at the emergency department with acute confusion. Initial CT brain is normal.

Patient Data

Age: 70-year-old
Gender: Female

MRI Brain (selected images)

MRI

There is a tiny punctiform focus of restricted diffusion in the left hippocampus. The brain is otherwise unremarkable. 

Case Discussion

The case demonstrates only a subtle abnormality characterized by restricted diffusion involving the left hippocampus, which definitely represents a recent ischemia. The question remains if it is either a small focus of thromboembolic ischemia or if it is related to a transient global amnesia. The latter has a diagnosis that should be made based on the clinical data, which for this case was not enough provided.

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