Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4494
Peer-review started: June 25, 2020
First decision: August 8, 2020
Revised: August 12, 2020
Accepted: September 4, 2020
Article in press: September 4, 2020
Published online: October 6, 2020
Processing time: 94 Days and 22.1 Hours
Stroke is an important cause of maternal morbidity and mortality during pregnancy and puerperium. Isolated amnesia is a rare clinical symptom caused by ischemic stroke during pregnancy. We present the first documented case of acute amnesia during pregnancy due to bilateral fornix infarction.
A 32-year-old nullipara presented at 35 wk of gestation with acute amnesia and headache. Brain magnetic resonance imaging and angiography revealed acute infarction in the bilateral anterior fornix. There was no evidence of causative abnormality after extensive work-up, including for vascular abnormality, cardiac disease, coagulopathy, and pregnancy-related conditions. The patient was diagnosed with cryptogenic stroke. Aspirin was administered immediately, and the patient recovered fully without recurrence.
Acute isolated amnesia due to stroke is rare during pregnancy. Early diagnosis of stroke and immediate treatment prevent neurologic sequelae.
Core Tip: Pregnancy-related cerebrovascular disorder is one of the major causes of maternal mortality. Arterial ischemic infarction is a less common complication, however, more critical and disabling. Isolated amnesia is a rare clinical symptom caused by ischemic stroke in pregnancy. We present a rare case of acute amnesia due to bilateral fornix infarction in healthy young nullipara. Extensive work up for stroke revealed no causative abnormality. The patient was diagnosed as cryptogenic stroke. This case highlights the early diagnosis and treatment for stroke in pregnancy with acute amnesia without another neurologic deficit.