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Focal damage to the fornices is uncommon and may be due to surgical removal of ventricular cysts and tumours.1 We report a case of bilateral fornix infarction with reduced fractional anisotropy values at 3 T after anterior communicating artery aneurysm clipping.
A healthy 33-year-old woman was admitted to our hospital with the incidental finding of an anterior communicating artery (ACoA) aneurysm on magnetic resonance angiography. Neurological examination was normal. Digital subtraction angiography visualised a broad based, tapered and 4 mm sized aneurysm of the ACoA and a median callosal artery (fig 1C). The ACoA aneurysm was treated with surgical clipping because of its irregular configuration. After surgery, the patient was drowsy with fluctuating impaired vigilance. She was disoriented in time, space and person, and revealed anterograde amnesia and amnesic aphasia. Her relatives noticed personality changes, psychomotor slowing and decreased spontaneity of speech and behaviour. Apart from transient mild right sided facial paresis, motor function of the limbs, deep tendon reflexes, sensory and coordinative examination and cranial nerves were normal. During the next 5 weeks of neurological rehabilitation, cognitive performance improved considerably. Seven weeks after the operation, she was orientated in all qualities and initial deficits in attentional performance and executive functions recovered. However, neuropsychological testing at this time revealed an average performance on …
Competing interests: None.
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