Progressive decrease in N-acetylaspartate/Creatine ratio in a teenager with type 1 diabetes and repeated episodes of ketoacidosis without clinically apparent cerebral edema: Evidence for permanent brain injury

AJNR Am J Neuroradiol. 2010 Apr;31(4):780-1. doi: 10.3174/ajnr.A1829. Epub 2009 Nov 19.

Abstract

Recent data suggest that DKA may contribute to cognitive impairment in children with type 1 DM. We measured the NAA/Cr ratio in a teenager during and following 2 separate episodes of DKA without clinically apparent cerebral edema. The NAA/Cr ratio decreased during DKA and improved following recovery. However, the NAA/Cr value was lower after the second episode of DKA (1.76) than after the first (1.97). These findings provide support for the hypothesis that neuronal injury may result from DKA.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Basal Ganglia / physiology
  • Blood Glucose / metabolism
  • Brain / physiopathology*
  • Brain Damage, Chronic / diagnosis*
  • Brain Damage, Chronic / physiopathology
  • Brain Edema / diagnosis*
  • Brain Edema / physiopathology
  • Creatine / metabolism*
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetic Ketoacidosis / diagnosis*
  • Diabetic Ketoacidosis / physiopathology
  • Dominance, Cerebral / physiology
  • Humans
  • Magnetic Resonance Spectroscopy*
  • Male

Substances

  • Blood Glucose
  • Aspartic Acid
  • N-acetylaspartate
  • Creatine