Browse > Article
http://dx.doi.org/10.13104/jksmrm.2014.18.4.357

Rapid Regression of White Matter Changes in Hypoglycemic Encephalopathy  

Son, Sang-Wook (Department of Radiology, Dankook University Hospital)
Lee, Kye-Ho (Department of Radiology, Dankook University Hospital)
Yoo, Dong-Soo (Department of Radiology, Dankook University Hospital)
Publication Information
Investigative Magnetic Resonance Imaging / v.18, no.4, 2014 , pp. 357-361 More about this Journal
Abstract
Purpose : In a previous report, it took several days for white matter lesions to regress in hypoglycemic encephalopathy. We present a case of rapid diffusion-weighted image (DWI) changes in hypoglycemic encephalopathy. Case Report: A 58-year-old male patient was found semi-comatous with the only abnormality in his laboratory tests showing hypoglycemia (44 mg/dL). After rapid correction of glucose level, immediate brain DWI showed bilateral subcortical white matter lesions. After about 5 hours, follow-up DWI showed resolved subcortical white matter lesions, with newly-appeared bilateral fronto-temporo-parietal cortical lesions. Conclusion: Both white matter and cortex involvement in hypoglycemic encephalopathy has been shown in several reports, but rapid regression of white matter changes in hypoglycemic encephalopathy has been rarely reported. It is important to know that MR imaging changes in hypoglycemic encephalopathy can be made as quick as just a few-hour-long.
Keywords
Hypoglycemic encephalopathy; Diffusion-weighted image; White matter;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Lee CY, Liou KC, Chen LA. Serial magnetic resonance imaging changes in hypoglycemic encephalopathy. Acta Neurol Taiwan 2013;22:22-25
2 Auer RN. Progress review: hypoglycemic brain damage. Stroke 1986;17:699-708   DOI   ScienceOn
3 Pelligrino D, Almquist LO, Siesjo BK. Effects of insulin-induced hypoglycemia on intracellular pH and impedance in the cerebral cortex of the rat. Brain Res 1981;221:129-147   DOI   ScienceOn
4 Ma JH, Kim YJ, Yoo WJ, et al. MR imaging of hypoglycemic encephalopathy: lesion distribution and prognosis prediction by diffusion-weighted imaging. Neuroradiology 2009;51:641-649   DOI   ScienceOn
5 Yoneda Y, Yamamoto S. Cerebral cortical laminar necrosis on diffusion-weighted MRI in hypoglycaemic encephalopathy. Diabet Med 2005;22:1098-1100   DOI   ScienceOn
6 Hasegawa Y, Formato JE, Latour LL, et al. Severe transient hypoglycemia causes reversible change in the apparent diffusion coefficient of water. Stroke 1996;27:1648-1655   DOI   ScienceOn
7 Aoki T, Sato T, Hasegawa K, Ishizaki R, Saiki M. Reversible hyperintensity lesion on diffusion-weighted MRI in hypoglycemic coma. Neurology 2004;63:392-393   DOI   ScienceOn
8 Hassel B, Boldingh KA, Narvesen C, Iversen EG, Skrede KK. Glutamate transport, glutamine synthetase and phosphateactivated glutaminase in rat CNS white matter. A quantitative study. J Neurochem 2003;87:230-237   DOI
9 Fujioka M, Okuchi K, Hiramatsu KI, Sakaki T, Sakaguchi S, Ishii Y. Specific changes in human brain after hypoglycemic injury. Stroke 1997;28:584-587   DOI   ScienceOn
10 Mori F, Nishie M, Houzen H, Yamaguchi J, Wakabayashi K. Hypoglycemic encephalopathy with extensive lesions in the cerebral white matter. Neuropathology 2006;26:147-152   DOI   ScienceOn