Neuropathologic examination of two patients with dementia showed chronic bilateral medial temporal lobe ischemic damage that included the hippocampus (particularly the CA-1 region), subiculum, and amygdala. Both patients had several myocardial infarctions, and the relatively circumscribed cerebral injury may have resulted from one or more episodes of global hypoxic ischemia. Focal hippocampal injury has been associated with amnesia. The additional damage to medial temporal lobe structures may have caused the dementia.