Utility of Diffusion-Weighted Magnetic Resonance Imaging for Predicting a Prognosis in Hypoglycemic Encephalopathy: Two Case Reports
Syuichi Tetsuka, Asako Tagawa, Tomoko Ogawa, Mieko Otsuka, Ritsuo Hashimoto, Hiroyuki Kato
International Journal of Medical and Pharmaceutical Case Reports · pp. 1–6 · Published 16 Jul 2015
10.9734/IJMPCR/2015/19534Abstract
Cases: Case 1: A 71-year-old male with a long history of chronic alcoholism was transferred to our emergency department because of a disturbance of consciousness. On arrival, his Glasgow Coma Scale (GCS) was E1V1M2 (4/15) and blood glucose level was 30 mg/dL. Case 2: A 66-year-old female with dermatomyositis and a long history of steroid-induced diabetes mellitus, who was treated with a sulfonylurea, was transferred to our department because of an altered mental state. Her GCS was E3V2M4 (9/15) and blood glucose level was 32 mg/dL. We observed abnormalities on diffusion-weighted magnetic resonance images (DWI-MRI) in both cases. Outcomes: Although intravenous thiamine and glucose was immediately administered because of suspected hypoglycemic encephalopathy, case 1 died after 3 days, and case 2 remained in a persistent vegetative state more than 90 days after onset. Conclusion: Unlike conventional MRI, DWI-MRI abnormalities can be used as predictors of poor prognosis in patients with severe hypoglycemia.
References (8)
- 1 National Trends in US Hospital Admissions for Hyperglycemia and Hypoglycemia Among Medicare Beneficiaries, 1999 to 2011 [DOI]
- 2 Specific Changes in Human Brain After Hypoglycemic Injury [DOI]
- 3 Reversible hyperintensity lesion on diffusion-weighted MRI in hypoglycemic coma [DOI]
- 4 Diffusion-weighted MR in hypoglycemic coma [DOI]
- 5 Clinical and Radiological Spectrum of Posterior Reversible Encephalopathy Syndrome [DOI]
- 6 Bilateral Temporal Lobe MRI Changes in Uncomplicated Hypoglycemic Coma [DOI]
- 7 Diffusion-weighted MRI predicts prognosis in severe hypoglycemic encephalopathy [DOI]
- 8 Serial magnetic resonance imaging changes in hypoglycemic encephalopathy.
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