When someone thinks of the concept of amnesia, a scene from a movie or TV show probably comes to mind. Usually, they depict a patient who doesn’t know who he is or recognize the people around him. It usually occurs after a serious and spectacular accident and generally makes him forget years of his life. This week, Anne of England, sister of King Charles III, suffered from amnesia. a head injury when a horse hit his head and he doesn’t remember anything that happened.
This complication that has suffered royal is called retrograde amnesia and it can happen for two reasons. After the blow, a hematoma can occur in one of the areas responsible for memory, explains Marta Ochoa, director of Neurology at HM Hospitals in Madrid. Another reason may be the power of the impact (very typical in horses and car accidents): if it is very strong, the brain can move inside the skull and hit, she adds. A case like that of the princess of England is usually quite common.
In head traumas, even if they are mild, memory loss is usually typical, Ochoa explains. The most common is that the memory of the nearest hours disappears. Thus, the patient does not remember what the accident was like, as happens to the princess of England. That does not mean that there are not patients who can forget a longer period of time that can even span years. “We have had patients who did not remember that they had had a child,” says Myrtha O’Valle, director of the Irenea Neurorehabilitation Institute of Vithas Sevilla.
The two neurologists send a message of calm and clarify that, in most cases, patients recover these erased memories. It may be that patients who do not know how their accident happened do not recover that memory because they have not managed to store it in their memory, says Ochoa. “As if you turn off the computer without saving a file”, exemplifies the neurologist from HM Hospitales. The most common thing is that the person who suffers from it forgets the last hours or days. When prolonged amnesia occurs, especially for years, the origin is usually psychological, explains Ochoa.
The loss of memories in these cases does not have to be chronological and may have gaps of various periods of time, according to O’Valle. When memories have an emotional burdenare stored in a different part of the brain and more neurons are allocated to preserving them, says Ochoa. “I may have lost memories of my work, but not those of my life with my children.”
The first thing doctors ask a patient with a head injury is whether they have lost consciousness and whether they remember what happened. The person’s consciousness is a criterion for knowing the severity of the prognosis and amnesia serves as a signal to detect brain injuries. If someone does not remember what happened after a blow, tests will be carried out to check the state of their brain, explains the neurologist at HM Hospitals. O’Valle, from Vithas, points out that the risk of losing memory after a concussion is quite high because one of the most affected areas is the temporal lobe, which is responsible for memory.
If a person receives a blow to the head and loses consciousness, the appropriate thing to do is call emergencies. “The patient must be evaluated even if the condition is not serious”, highlights Ochoa. It is also important to calm him down, if he comes to, and prevent him from getting upset. In no case should he be moved: these accidents are often related to cervical injuries and his situation can worsen, even leaving him paraplegic, according to the HM Hospitales neurologist.
Anterograde amnesia
What is really worrying in these situations is that the patient loses the ability to generate new memories. This phenomenon is called anterograde amnesia and those who suffer from it cannot assimilate new experiences after the accident. It is also “a predictor of the severity of the trauma,” says Ochoa. This sequel is also associated with behavioral disorders, irritability, and disorientation, among others.
If a patient He is not able to remember what he is doingwill have many problems in their daily life. They may even forget that they have eaten and do it again, O’Valle exemplifies. What is recommended to these people is that they write down the actions carried out so that they can know what they have done and what they have not, adds Ochoa.
How do you work with patients?
The way to treat each amnesia is different. If the patient cannot generate new memories, the first thing is to rehabilitate attentional processes, explains O’Valle. “Normally, after a memory problem there can be another attention problem”. Then the learning capacity is worked on so that new knowledge can be acquired. The process is called cognitive rehabilitation and is worked on with neuropsychology sessions, says Ochoa.
When what is affected are memories of the past, we work with autobiographical materials. “We tell family members to talk to them about common memories, to show them photos,” says the HM Hospitales neurologist. O’Valle emphasizes that this material must be important to patients. For this rehabilitation, the exercises are very personalized and they are intended to be within the patient’s area of interest in order to establish an “emotional thread” that reconnects the patient with her memory.
This is not always the case. There are cases in which these people cannot remember some past moments, but they do know about them through their loved ones. “They tell us they don’t remember it, but they have told them”explains the neurologist from Vithas. This creates what she calls a “false memory” because the person is not really aware of what has happened. This is one of the after-effects suffered by José Marín, vocalist of Supersubmarina, after the accident that the group suffered. He has no memories of when the band was active.
Suffering from amnesia greatly affects the patient’s quality of life, especially if it is anterograde. When a person loses the ability to learn, they cannot consolidate information and this affects all areas of life, explains O’Valle. “Without memory and without being able to have new memories, as human beings we are useless”Ochoa says.
Suffering from this after-effect can be a risk factor for developing subsequent cognitive impairment such as dementia, warns Ochoa. The two neurologists emphasize that if a patient believes that they have memory loss after a head injury, whether serious or not, they should inform their doctor. “With cognitive rehabilitation, it can improve”concludes the neurologist from HM Hospitales.
