Memory Impairment Due to a Small Acute Infarction of the Columns of the Fornix

Memory Impairment Due to a Small Acute Infarction of the Columns of the Fornix

Background: Clinically infarction of the columns of the fornix is very rare. It is also easy to be overlooked during imaging examination due to the special anatomical localization and features of columns of the fornix. In the meantime, with memory disorder to be its most prominent manifestation, it is very easily false diagnosed as other diseases when the lesion focus is overlooked, causing unnecessary invasive examinations like cerebrospinal fluid tests. Methods: Case report and Literature review. Results: We presented a 66-year-old woman with memory impairment due to a small acute infarction of the columns of the fornix. Through her diagnosis and treatment, we believed that early diagnosis and treatment were important to these patients who were enduring the disease. In addition, literature review informed us that for those unwilling to undergo cerebral angiography or for small cerebrovascular lesions that cannot be detected by angiography, 7T magnetic resonance imaging (MRI) might be an ideal diagnostic method. Conclusion: This case illustrated the significance of MM in diagnosis for patients with acute memory impairment. When reading MRI results, one needs to pay attention to identify small lesions at special locations. In addition, cerebral apoplexy is still the first consideration of diagnosis when acute memory impairment occurs in patients with cerebrovascular disease risk factors.

背景：临床上穹窿柱梗死非常罕见。由于穹窿柱特殊的解剖定位和特征，在影像学检查中也容易被忽视。同时，以记忆障碍为其最突出的表现，当病灶被忽视时很容易被误诊为其他疾病，导致不必要的侵入性检查，如脑脊液检查。 方法：病例报告和文献综述。 结果：我们介绍了一名66岁女性，因穹窿柱小面积急性梗死而出现记忆障碍。通过对她的诊断和治疗，我们认为早期诊断和治疗对这些患病的患者很重要。此外，文献综述告诉我们，对于那些不愿意接受脑血管造影或造影无法检测到的小脑血管病变，7T磁共振成像（MRI）可能是一种理想的诊断方法。 结论：本病例说明了MRI在急性记忆障碍患者诊断中的重要性。在阅读MRI结果时，需要注意识别特殊部位的小病灶。此外，当有脑血管疾病危险因素的患者出现急性记忆障碍时，脑卒中仍然是诊断的首要考虑因素。