Teaching NeuroImages: Amnesia due to fornix infarction
B. L. Adamovich, MD,
G. Gualberto, MD,
T. Roberts, MD,
M. W. Haut, PhD and
L. Gutmann, MD
From the Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown.
Address correspondence and reprint requests to Dr. Ludwig Gutmann, Robert C. Byrd Health Sciences Center, PO Box 9180, WV University, Morgantown, WV 26506-9180 lgutmann{at}wvu.edu
A 53-year-old right-handed teacher developed acute confusionand short-term memory difficulties, including significant retrogradeand anterograde amnesia. Intellect remained intact. She repeatedphrases spoken recently without recall and asked inappropriatequestions.
Mini-Mental State Examination was normal except for inabilityto recall any of 3 objects after 5 minutes. She had no otherneurologic abnormalities. CT angiogram and transesophageal echocardiogramshowed no thromboembolic source. Amnesia persisted 2 monthslater.
Amnesia with infarction of anterior fornices (figure) has beenrarely described. Small vessel disease of the perforating branchesarising from the anterior cerebral or anterior communicatingarteries1,2 was the likely source of the infarct.
Figure Diffusion-weighted axial (A) and sagittal (B) MRI demonstrating an acute infarction of the anterior fornices
Disclosure: Dr. Adamovich and Dr. Gualberto report no disclosures.Dr. Roberts received funding for travel from Johnson & Johnson.Dr. Haut receives honoraria for serving on an NIH Study Section(Adult Psychopathology and Disorders of Aging Study Section);serves on the editorial board of Aging, Neuropsychology andCognition; and has served as an expert witness in medicolegalproceedings. Dr. Gutmann has received research support for trialssponsored by Jacobus Pharmaceutical Company, Inc. (PI), JacobusPharmaceutical Company, Inc. (PI), Genzyme Corporation (PI),Schwarz Biosciences (coinvestigator), Avanair Pharmaceuticals(coinvestigator), and Biogen Idec, Inc. (coinvestigator).
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