Monday, January 29, 2007

TGA Mechanism

Bartsch T et al. Brain 2006;129:2874-2884. Selective affection of hippocampal CCA-1 neurons in patients with TGA without long term sequelae.

71 percent occurred after physical exertion, stress, Vasalva, or postural changes, most in the morning or afternoon. Of 41 patients, 29 had 36 DWI lesions and corresponding T2 lesions in hippocampus 48-72 hours after , almost all (34/36) in CA1 secotr, one in CA3 sector and one in cornu ammonis. Left sided lesions favored 20-16 with episodic verbal deficits seen in those tested acutely and visuospatial deficits in those with right sided lesions tested acutely. MRI lesions did not persist.

A hypoplastic transverse sinus with slight left sided predominance was seen in 88 %