Case Of the Week (COW) 11 October 2015
Hypoglycemic encephalopathy
Findings:
Known case of diabetic admitted with complaints of sudden Loss of consciousness Blood sugar level – 25 mg/dl Findings – T2/FLAIR Hyperintensity with diffusion restriction noted in the splenium of corpus callosum , internal capsule,caudate nuclei , and corona radiata.
Discussion:
Characteristic MR imaging findings of severe hypoglycemia include bilateral T2 prolongation in the cerebral cortex ,hippocampi and basal ganglia In some cases of milder, reversible hypoglycemia, transient and isolated white matter abnormalities involving the splenium of carpus callosum , internal capsule and corona radiata have been reported , with patients making full recovery without neurological deficit, however white matter lesion may also be seen in combination with diffuse grey matter abnormalities. The abnormal areas are typically hyperintense on diffusion weighted MR images and show reduced apparent diffusion coefficient. Involvement of basal ganglia seems to portend poor prognosis.
Contributed By:
Prof. S Babu Peter, Dr.M.P.Balan, Dr.K.Janakiraman, Dr.Rooba lakshmi
Barnard Institute of Radiology
Hypoglycemic encephalopathy
Findings:
Known case of diabetic admitted with complaints of sudden Loss of consciousness Blood sugar level – 25 mg/dl Findings – T2/FLAIR Hyperintensity with diffusion restriction noted in the splenium of corpus callosum , internal capsule,caudate nuclei , and corona radiata.
Discussion:
Characteristic MR imaging findings of severe hypoglycemia include bilateral T2 prolongation in the cerebral cortex ,hippocampi and basal ganglia In some cases of milder, reversible hypoglycemia, transient and isolated white matter abnormalities involving the splenium of carpus callosum , internal capsule and corona radiata have been reported , with patients making full recovery without neurological deficit, however white matter lesion may also be seen in combination with diffuse grey matter abnormalities. The abnormal areas are typically hyperintense on diffusion weighted MR images and show reduced apparent diffusion coefficient. Involvement of basal ganglia seems to portend poor prognosis.
Contributed By:
Prof. S Babu Peter, Dr.M.P.Balan, Dr.K.Janakiraman, Dr.Rooba lakshmi
Barnard Institute of Radiology