Rapid improvement of diffusion-weighted imaging abnormalities after glucose infusion in hypoglycaemic coma

Maruya, Jun; Endoh, Hidenori; Watanabe, H; Motoyama, H; Abe, Hironori

doi:10.1136/bcr.07.2008.0514

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…Diffusion-weighted imaging of the affected region in hypoglycemic encephalopathy has shown high intensity in the basal ganglia, pons, temporal lobe or occipital lobe of the cortex, hippocampus, splenium of corpus callosum, and other areas. 1,3,6,[8][9][10]12,13) The cortex, basal ganglia, and hippocampus are the most vulnerable to hypoglycemia, 2) but high intensity has been observed only in the splenium of corpus callosum or basal ganglia without lesions in the cortex or hippocampus as in the present case. 3,6,[8][9][10]13) The high intensity areas on diffusion-weighted images during hypoglycemia disappear after correction of hypoglycemia within 2 hours, 12) and within 10 minutes in an animal experiment using rats.…”

Section: Discussionmentioning

confidence: 62%

“…On the other hand, magnetic resonance (MR) imaging may detect areas of abnormal intensity in patients with hypoglycemia. 3,6,[8][9][10]12,13) We describe rare MR imaging findings in a case of hypoglycemia. Diffusion-weighted imaging revealed reversible hyperintensity of the splenium of corpus callosum with decreased apparent diffusion coefficient (ADC) of the posterior limb of the internal capsule.…”

Section: Introductionmentioning

confidence: 99%

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Reversible Magnetic Resonance Imaging Changes Associated With Hypoglycemia -Case Report-

Yamashita

Kawakita

Hosomi

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 63-year-old man was found with confusion and right limb monoparesis. He was taken to the emergency center under suspicion of stroke. Head computed tomography and magnetic resonance (MR) imaging and MR angiography were immediately conducted, which revealed no abnormality, but diffusionweighted imaging showed increased intensity areas in the splenium of the corpus callosum and the left posterior limb of the internal capsule with decreased apparent diffusion coefficient (ADC) in the same areas. Immediately after the head scan, blood sugar level was measured, which revealed hypoglycemia (23 mg/dl). He quickly became lucid after intravenous administration of 20 ml of 50% glucose solution, and the paresis disappeared. Follow-up brain MR imaging was conducted 3 days later, but no clearly abnormal findings were seen on T 2 -weighted, fluid-attenuated inversion recovery, diffusion-weighted, or ADC images. Reports of reversible high intensity area in the splenium of the corpus callosum on diffusion-weighted imaging due to transient hypoglycemia are rare. Hemiparesis is one of the manifestations of hypoglycemia, so verifying the blood sugar level is important. Since MR imaging can be conducted easily now, we may need to consider the imaging findings in the differential diagnosis of hypoglycemia.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Reversible Magnetic Resonance Imaging Changes Associated With Hypoglycemia -Case Report-

Yamashita

Kawakita

Hosomi

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…In den T2-Flair-Sequenzen sind initial zunächst meist keine hyperintensen Demarkierungen sichtbar. Diese zeigen sich erst nach einer Latenz von mehreren Stunden [8][9][10][11].…”

Section: Zerebrale Diagnostik Bei Und Nach Akuter Hypoglykämieunclassified

Hypoglykämien und Gehirn

Erbguth

2019

Diabetes aktuell

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ZUSAMMENFASSUNGAufgrund seiner energetischen Abhängigkeit von der direkten Glukosezufuhr ist das menschliche Gehirn gegenüber Hypoglykämien sehr vulnerabel. Schwere Hypoglykämien führen zu Bewusstseinsstörungen, schlaganfallähnlichen fokalen motorischen Symptomen und Krampfanfällen. Akute Funktionsstörungen können bei schwerer hypoglykämischer Exposition in irreversible neuronale Zellschädigungen übergehen. Zerebrale Regulationsmechanismen tragen nach rezidivierenden Hypoglykämien zur Ausbildung einer Hypoglykämie-Wahrnehmungsstörung bei, die das Risiko schwerer Hypoglykämien weiter erhöht. Bei Typ-1-Diabetespatienten konnten bis ins mittlere Lebensalter keine negativen kognitiven Auswirkungen vermehrter Hypoglykämien bewiesen werden, allerdings ist offen, ob sich diese möglicherweise erst in höherem Lebensalter manifestieren. Bei Typ-2-Diabetespatienten bestehen bi- oder sogar tridirektionale kausale Zusammenhänge zwischen eingeschränkter Kognition, Hypoglykämien und einer schlechten glykämischen Kontrolle.

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“…, Maruya et al . ) to persistent neurologic deficits, persistent vegetative state and death (Mori et al . , Ma et al .…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology and aetiology of hypoglycaemic crises

Morgan¹,

Cortes²,

Murphy³

2018

J of Small Animal Practice

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Hypoglycaemia is a common, life-threatening complication that occurs as a component of a wide variety of disease processes. Despite its frequent occurrence, information concerning the aetiology, characteristics and outcomes of hypoglycaemic crises in veterinary medicine is limited. This review summarises the current understanding of the pathophysiology of hypoglycaemia, the body's counterregulatory response, underlying aetiologies, diagnosis and treatment. Disease mechanisms are discussed and published evidence in veterinary literature regarding prognostic indicators, prevalence, diagnosis and treatment is examined for hypoglycaemia-related disease processes including insulinoma, glucose-lowering toxins and medications.

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Rapid improvement of diffusion-weighted imaging abnormalities after glucose infusion in hypoglycaemic coma

Cited by 9 publications

References 6 publications

Reversible Magnetic Resonance Imaging Changes Associated With Hypoglycemia -Case Report-

Reversible Magnetic Resonance Imaging Changes Associated With Hypoglycemia -Case Report-

Hypoglykämien und Gehirn

Pathophysiology and aetiology of hypoglycaemic crises

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