The Significance of Atrial Fibrillation in Patients With Transient Global Amnesia

Background and Purpose: The etiology of transient global amnesia (TGA) remains unclear in a large subset of patients. We aimed to determine the clinical and radiological characteristics of TGA-patients with suspected acute micro-embolic stroke on diffusion-weighted imaging (DWI). Methods: TGA-patients that had new DWI hippocampal lesions (DWI+) were compared to DWI negative TGA-patients (DWI–). Demographics, risk factors, clinical data, radiological data, and mortality were analyzed. Results: Out of 83 patients diagnosed with TGA, 56 (65%) underwent MRI during the acute hospitalization and 26 (46%) had new hippocampal DWI lesions. DWI+ patients more often had a history of atrial fibrillation (AF, 26 vs. 7%, p = 0.04) but the frequency of other risk factors did not differ. None of the patients died, however, two DWI+ patients had subsequent stroke during a 2-year follow up and both had AF. In contrast, none of the DWI- patients had recurrent events. Conclusion: AF is common among DWI+ TGA-patients. The presence of AF in patients with TGA could suggest an increased risk of subsequent stroke.