THE FIRST KNOWN CASE OF SPLENIAL HAEMORRHAGE PRESENTING WITH ACUTE AMNESIA

Abstract Ref: 
0243

Yoann O’Donoghue1, John McCabe2, Aileen O’Shea3, Alan Moore2

1School of Medicine, Trinity College Dublin, Dublin, Ireland
2Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland and
Beaumont Hospital, Dublin 11, Ireland
3Department of Radiology, Beaumont Hospital, Dublin 11, Ireland

Background: Isolated splenial haemorrhage is rare. There are several reports of retrosplenial
or hippocampal lesions presenting with amnesia, however there are no previous
case reports of isolated splenial haemorrhage with this presentation. We report the first
know case of splenial haemorrhage presenting with amnesia.
Methods: We reviewed the clinical and radiological findings of a 66 year-old man who
presented with retrograde and anterograde amnesia of 6 hours duration. A literature
review was carried out of previous reports of splenial lesions, in particular splenial haemorrhage,
and their presentations.
Results: The patient was admitted with a working diagnosis of transient global amnesia
(TGA). His past medical history was unremarkable. Neurological examination and initial
CT brain were normal. MOCA revealed isolated impairments in visuospatial function.
MRI brain revealed a small focus of haemorrhage in the left splenium. Our
literature review demonstrated one case report of an isolated splenial lesion presenting

with acute amnesia secondary to ingestion of herbicide, but none secondary to
haemorrhage.
Conclusion: The diagnosis of acute amnestic syndromes remains challenging. Isolated
splenial lesions as a cause of acute amnesia are very rare. This case highlights the importance
of performing appropriate neurological investigations in patients presenting with
acute amnesia as TGA remains a diagnosis of exclusion.