Acute brain injury in hypoglycaemia‐induced hemiplegia

Abstract

This report provides evidence that acute brain injury may be a cause of the neurological deficit.

Diffusion MR Imaging of Hypoglycemic Encephalopathy

“…17 Some authors have reported DWI and ADC findings of HE. [1][2][3][5][6][7][8][9][10][11][12][13][14][15][16]18 According to previous reports, the lesions show reversible cytotoxic edema at the cerebral cortex, 14,15,18 hippocampus, 19 splenium, 7,11,12,16 IC, 13,16 and cerebral WM. 5,8 These diffusion alterations are encountered not only in acute ischemia but also in hypoglycemia itself, and in vivo animal model studies have demonstrated diffusion alterations due to hypoglycemia.…”

“…15 Hypoglycemia can cause various neurologic symptoms including profound memory loss, transient motor deficits, a persistent vegetative state, and death in 2%-4% of cases. [1][2][3]13 Brain MR imaging is a useful technique to evaluate severe HE. Among other sequences, DWI is a special technique that can measure the alteration of the diffusion of water within the extracellular space and between intracellular and extracellular spaces.…”

“…These neurologic symptoms range from focal neurologic deficits to permanent dysfunction or death. [1][2][3] Neuropathologic studies have demonstrated that the cerebral cortex, hippocampus, and BG are commonly affected sites in severe hypoglycemia; however, the cerebellum and brain stem are usually spared. [4][5][6][7][8][9][10] In addition, unlike hypoxic damage, the occipital cortex, dorsofrontal cortex, and hippocampus may be more resistant to prolonged hypoglycemia.…”

Reversible Diffusion-Weighted Imaging Changes in the Splenium of the Corpus Callosum and Internal Capsule Associated With Hypoglycemia -Case Report-

“…Diffusion-weighted magnetic resonance (MR) imaging is a useful method to detect early brain injury in the acute stage of ischemia, but is less well known in hypoglycemia-induced hemiparesis. 1,2,5,13,17) We report a case of hypoglycemia manifesting as hemiparesis in which diffusionweighted MR imaging demonstrated completely reversible signal changes in both the splenium of the corpus callosum and the posterior limb of the left internal capsule in the course of recovery.…”

Hemiparesis and lateralized cortical lesions associated to severe hypoglycemia

“…Usually, patients are in coma or with respiratory failure; in the clinical outcome, entire disappearance of clinical features and even death have been reported due to hypoglycemic encephalopathy, deep memory loss and persistent vegetative state 1,4,5 . Hemiparesis is a rare and/or under-diagnosed clinical manifestation of hypoglycemia 6,7 .…”