Localized reversible reduction of apparent diffusion coefficient in transient hypoglycemia-induced hemiparesis

Stroke. 2005 Mar;36(3):e20-2. doi: 10.1161/01.STR.0000155733.65215.c2. Epub 2005 Feb 3.

Abstract

Background and purpose: The pathophysiology of hypoglycemia shares a common mechanism with cerebral ischemia, but so far, little is known regarding MRI of humans with hypoglycemia.

Methods: We report a patient with left hemiparesis and dysarthria associated with a blood glucose level of 1.7 mmol/L. The patient recovered completely after glucose infusion.

Results: The initial diffusion-weighted imaging (DWI) showed increased signal intensities and a reduction of apparent diffusion coefficient (ADC) values localized in the corpus callosum (splenium) and asymmetrically in the corona radiata. After 48 hours, follow-up revealed complete recovery of DWI and ADC signal abnormalities.

Conclusions: To our knowledge, this is the first presentation of a case with transient hypoglycemia-induced focal neurological deficits revealing completely reversible MRI changes in terms of disturbed DWI and ADC with a peculiar as yet undescribed topography.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Glucose / metabolism
  • Blood Glucose / physiology
  • Diffusion Magnetic Resonance Imaging / methods*
  • Dysarthria / blood
  • Dysarthria / etiology
  • Humans
  • Hypoglycemia / complications*
  • Male
  • Paresis / blood*
  • Paresis / etiology*

Substances

  • Blood Glucose