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Yoneoka Y, Seki Y, Akiyama K. "Vascular" Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of "Acute" Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia. Cureus. 2021;13(11):e19472doi: 10.7759/cureus.19472.
Yoneoka, Y., Seki, Y., & Akiyama, K. (2021). "Vascular" Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of "Acute" Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia. Cureus, 13(11), e19472. https://doi.org/10.7759/cureus.19472
Yoneoka, Yuichiro, et al. ""Vascular" Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of "Acute" Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia." Cureus vol. 13,11 (2021): e19472. doi: https://doi.org/10.7759/cureus.19472
Yoneoka Y, Seki Y, Akiyama K. "Vascular" Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of "Acute" Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia. Cureus. 2021 Nov 11;13(11):e19472. doi: 10.7759/cureus.19472. eCollection 2021 Nov. PMID: 34912613; PMCID: PMC8664363.
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Cureus. 2021 Nov 11;13(11):e19472. doi: 10.7759/cureus.19472. eCollection 2021 Nov.

"Vascular" Korsakoff Syndrome With Bilaterally Damaged Mammillothalamic Tracts: Insights Into the Pathogenesis of "Acute" Korsakoff Syndrome As Acute-Onset Irreversible Anterograde Amnesia.

Cureus

Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama

Affiliations

  1. Department of Neurosurgery, Uonuma Kikan Hospital, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, JPN.

PMID: 34912613 PMCID: PMC8664363 DOI: 10.7759/cureus.19472

Abstract

The structural pathogenesis of Wernicke-Korsakoff syndrome remains debatable. Wernicke encephalopathy is acute and often reversible whereas Korsakoff syndrome (KS) is chronic and may be irreversible. The cognitive deficits observed in KS are considered to be primarily due to damage to the anterior nucleus of the thalamus, mammillary bodies, and corpus callosum. We present an extremely rare case of non-alcoholic "vascular" KS (vKS) as acute-onset amnesia. A 97-year-old man living alone was brought to our hospital, complaining of sudden-onset behavioral changes with amnesia. Diffusion-weighted images (DWIs) showed fresh cerebral infarction in the right thalamus involving the right mammillothalamic tract (MTT). T2*-weighted images (T2*WIs), in addition, revealed a microbleed scar over the left MTT. This case supports the hypothesis that bilateral MTT dysfunction can lead to KS. Furthermore, in collaboration with a prior report about non-alcoholic "acute" KS due to cerebral infarction, this case supports the existence of vascular KS as an acute-onset amnestic syndrome, as well as insight into the pathogenesis of KS as an irreversible amnestic syndrome.

Copyright © 2021, Yoneoka et al.

Keywords: acute cerebral infarction; anterograde amnesia; irreversible anterograde amnesia; magnetic resonance imaging; mammillothalamic tract; microbleeds; non-alcoholic korsakoff syndrome; papez circuit; pathogenesis of korsakoff syndrome; vascular korsakoff syndrome

Conflict of interest statement

The authors have declared that no competing interests exist.

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