Poster Abstracts

Abstract

Patients with severe memory impairment but otherwise preserved cognitive functioning due to focal hippocampal lesions are extremely rare. Here, we describe a potentially unique case resulting from diffuse large B cell secondary CNS lymphoma. Progression following standard chemoimmunotherapy required intrathecal chemotherapy via Ommaya catheter. MRI scans revealed bilateral hemorrhagic encephalomalacia limited almost exclusively to bilateral hippocampi.
Neuropsychological evaluation of the patient, a 55-year-old Caucasian man with 12 years of education, identified a profound impairment in memory recall (Hopkins Verbal Learning Test–Revised [HVLT-R] and Brief Visuospatial Memory Test–Revised [BVMT-R] Total Recall Ts=≤20, 23 and Delayed Recall Ts=≤20, ≤20, respectively) with preservation of general cognitive abilities (e.g., WASI-II FSIQ=102). Performance was normal in many cognitive domains (including low average or above attention, processing speed, visuospatial, and language), although there were indications of mild executive dysfunction (potentially predating his current illness). In contrast to the recall findings, visual recognition memory results were mixed (BVMT-R Recognition Discrimination Index was preserved [11-16%ile] but HVLT-R Recognition was not).
These findings, observed in the context of focal bilateral hippocampal damage, highlight long-appreciated contributions of the structure to healthy memory function, while offering potential support for hypothesized distinctions between processes supported by the hippocampus versus other brain structures.

First AuthorAlexandra A. Koller
Second AuthorAdrian W. Gilmore
Third AuthorSamantha Audrain
Fourth AuthorElyse Gollomp
Fifth AuthorDima Hammoud
Sixth AuthorAnna M. Agron
Seventh AuthorJenna Wilson
Eighth AuthorAlex Martin
Ninth AuthorJoseph Snow