Differential Diagnosis for Memory Recall Problems

The patient presents with normal vital signs, cognition, and unremarkable blood tests except for a high D-dimer level, which may indicate thrombotic activity. Given these details, the differential diagnosis can be categorized as follows:

• Single Most Likely Diagnosis

  • Transient Global Amnesia (TGA): This condition is characterized by sudden, temporary memory loss and confusion. It's often triggered by physical or emotional stress and can be associated with high D-dimer levels, suggesting a possible link to thrombotic events or vascular issues. The patient's high D-dimer and inability to recall information, despite having a normal Glasgow Coma Scale (GCS) score and no other significant findings, make TGA a plausible diagnosis.

• Other Likely Diagnoses

  • Early stages of Alzheimer's Disease or other dementias: Although less likely given the acute presentation, early stages of dementia can present with short-term memory loss. However, these conditions typically progress slowly and are accompanied by other cognitive deficits.
  • Medication side effects: Certain medications can cause memory problems as a side effect. Given the patient's otherwise normal presentation, it's possible that a recently initiated medication could be contributing to their symptoms.
  • Sleep disorders: Sleep apnea, insomnia, and other sleep disorders can significantly impact memory and cognitive function. If the patient has an underlying sleep issue, this could be contributing to their memory problems.
  • Depression or anxiety: Both conditions can affect memory and concentration. If the patient is experiencing significant psychological distress, this could manifest as memory recall problems.

• Do Not Miss Diagnoses

  • Stroke or Transient Ischemic Attack (TIA): Although the patient's GCS is 15/15 and other vital signs are normal, a stroke or TIA can sometimes present with isolated symptoms such as memory loss, especially if the area of the brain affected is involved in memory processing. The high D-dimer could suggest a thrombotic event.
  • Venous Thromboembolism (VTE): A high D-dimer level can indicate VTE, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). While these conditions primarily affect the respiratory and cardiovascular systems, in rare cases, they can lead to paradoxical embolism affecting cerebral function.
  • Brain tumor: Although rare, a brain tumor could potentially cause localized damage leading to memory problems, depending on its location.

• Rare Diagnoses

  • Encephalitis: Inflammation of the brain, usually due to viral infections, can cause memory problems among other symptoms. However, encephalitis typically presents with fever, headache, and altered mental status, which are not mentioned in the scenario.
  • Autoimmune disorders affecting the brain: Conditions like Hashimoto's encephalopathy or autoimmune limbic encephalitis can cause memory issues but are rare and usually accompanied by other neurological symptoms.
  • Vitamin deficiencies: Deficiencies in vitamins B12 or B6 can lead to neurological symptoms, including memory problems. However, these would likely be identified on blood tests, which were reported as unremarkable except for the high D-dimer.