While amnesia and other cognitive disturbances are usually caused by s
tructural brain damage, there are a few instances in which environment
al Stress may induce neuronal death in memory-sensitive brain regions
such as the hippocampus. Here we report on a patient who, after a sing
le brief exposure to an event reminding him of a similar stressful eve
nt from his childhood, deteriorated immediately and persistently witho
ut manifesting structural, but manifesting functional, brain damage as
measured by position emission tomography. This patient probably repre
sents the first case in which a direct relation between a single psych
ic event and the occurrence of brain malfunctioning in cognition is do
cumented by dynamic neuroimaging methods. Psychic shock may cause last
ing reductions in brain metabolism with the consequence of severe inte
llectual malfunctioning. (C) 1998 Elsevier Science Ltd. All rights res
erved.