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Acute amnesia associated with damaged fiber tracts following anterior fornix infarction

A 78-year-old woman developed sudden-onset confusion and memory impairment. Examination demonstrated both retrograde and anterograde amnesia. Mini-Mental State Examination score of 17 exhibited poor performance in delayed recall and orientation function. Brain diffusion-weighted imaging revealed an acute infarction of the anterior fornix. Repeat T1-weighted images at 17 days after onset showed hypointense lesions in the same region. Meanwhile, diffusion tensor tracking was performed and demonstrated that few fibers were followed (figure), using Siemens (Munich, Germany) Syngo software with the measures of fractional anisotropy threshold 0.15 and angle 30. The fornix constitutes a core element of the Papez circuit1,2 and acute amnesia was the result of damaged fiber tracts following anterior fornix infarction in this patient.