Susceptibility Weighted Imaging as a Useful Imaging Adjunct in Hemichorea Hyperglycaemia

Dharsono, Ferry; Thompson, Andrew; Heerden, Jolandi van; Cheung, Andrew

doi:10.1155/2013/456156

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…In this case, CT at the time of the second admission showed that the hyperdensity in the bilateral putamen had diminished compared with that at the time of the first admission; we speculate that the image change may have captured the process in which the hyperdensity that occurred at the time of the first admission was fading away. On MRI, T2-weighted, FLAIR, DWI, T2*, and SWI findings vary, although T1-weighted images typically show striatal hyperintensity [1,[8][9][10][11][12]. As in previous reports, striatal hyperintensity on T1-weighted MRI was the clearest diagnostic indicator of diabetic striatopathy in this case.…”

Section: Discussionsupporting

confidence: 54%

Characterization of Diabetic Striatopathy With Repeated Follow-Up Using Multiple Imaging Studies

Nishimura,

Kado,

Tobe

2024

Cureus

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Diabetic striatopathy is a rare condition with a prevalence of less than one in 100,000. Herein, we report a case of diabetic striatopathy exacerbated by hyperglycemia and hypoglycemia, with repeated follow-up with multiple imaging studies. This case suggested that putamen neuronal loss and dysfunction, gliosis, and ischemia are associated with diabetic striatopathy pathophysiology. In addition, striatal hyperintensity on T1-weighted MRI images was more pronounced after symptom remission when evaluated several times over a short period. Therefore, clinicians should be aware that even if MRI findings are normal in the very early stages of the onset of diabetic striatopathy, repeating MRIs at intervals may reveal typical findings.

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Section: Discussionsupporting

confidence: 54%

Characterization of Diabetic Striatopathy With Repeated Follow-Up Using Multiple Imaging Studies

Nishimura,

Kado,

Tobe

2024

Cureus

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“…Similarly, Dharsono et al, in a single case observed over 5 months, an improvement of hyperintensity on T1-MRI and a more extensive and increased SWI hypointensity within the affected corpus striatum, suggesting an ongoing process of deposition of paramagnetic material. Iron-deposition-related neurotoxicity could explain the progressive malacic change demonstrated on follow-up imaging [ 56 ] ( Table 1 ). Cherian et al suggested a paramagnetic mineral deposition in the affected putamen caused by swollen gemistocytes that express metallothionein and zinc secondary to ischemic insult [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

An Updated Overview of the Magnetic Resonance Imaging of Brain Iron in Movement Disorders

Tambasco

Nigro

Chiappiniello

et al. 2022

Behavioural Neurology

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Brain iron load is one of the most important neuropathological hallmarks in movement disorders. Specifically, the iron provides most of the paramagnetic metal signals in the brain and its accumulation seems to play a key role, although not completely explained, in the degeneration of the basal ganglia, as well as other brain structures. Moreover, iron distribution patterns have been implicated in depicting different movement disorders. This work reviewed current literature on Magnetic Resonance Imaging for Brain Iron Detection and Quantification (MRI-BIDQ) in neurodegenerative processes underlying movement disorders.

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“…Other earlier studies used different imaging modalities in an attempt to elucidate the cellular function and perfusion status of the affected region. For instance, studies from DWI [ 54 ] and susceptibility-weighted MRI [ 55 ] suggested hyperviscosity with a cytotoxic edema and the deposition of paramagnetic material, respectively. Positron emission tomography studies demonstrated a marked decrease in glucose metabolism within the lesioned basal ganglia [ 20 , 56 ] and single-photon emission CT mostly revealed hypoperfusions in the corresponding region [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetic Striatopathy: Parenchymal Transcranial Sonography as a Supplement to Diagnosis at the Emergency Department

Godani¹,

Lanza

2022

Diagnostics

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Background: Diabetic striatopathy (DS) is a rare condition with a debated pathophysiology; a local metabolic dysfunction is the most likely hypothesis. We present a case of DS mimicking an acute stroke, outline a few uncommon/atypical features, and report for the first time the parenchymal transcranial sonography (pTCS) findings. Case Report: An 86-year-old man, treated for insulin-dependent diabetes, presented at an emergency department because of the occurrence of isolated choreo-athetotic movements in his left limbs with fluctuations in the location, frequency, and duration. The blood glucose level was 569 mg/dL. Both urgent and follow-up brain computed tomography (CT) were negative for recent lesions whereas pTCS revealed hyperechogenicity in the right lenticular nucleus. Subsequent magnetic resonance imaging (MRI) showed T1-weighted hyperintensity in the right putamen with negative diffusion-weighted imaging. The symptoms were responsive to glucose control and haloperidol administration, although they persisted during sleep. Conclusions: Unlike previously described cases characterized by hemichorea and/or hemiballism, our patient presented with a stroke-like onset of unilateral irregular choreo-athetotic movements. Notably, based on CT alone, it would not have been possible to distinguish DS from a stroke. In this scenario, the pTCS hyperechogenicity of the right lenticular nucleus helped to hypothesize a metabolic disorder, which was subsequently confirmed by MRI.

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Susceptibility Weighted Imaging as a Useful Imaging Adjunct in Hemichorea Hyperglycaemia

Cited by 6 publications

References 15 publications

Characterization of Diabetic Striatopathy With Repeated Follow-Up Using Multiple Imaging Studies

Characterization of Diabetic Striatopathy With Repeated Follow-Up Using Multiple Imaging Studies

An Updated Overview of the Magnetic Resonance Imaging of Brain Iron in Movement Disorders

Diabetic Striatopathy: Parenchymal Transcranial Sonography as a Supplement to Diagnosis at the Emergency Department

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