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Case No. 387
2015-10-01~2015-10-31
출제자 : 차지훈
Hit : 362
| Period | 2015-10-01~2015-10-31 |
|---|---|
| Diagnosis | Hypoglycemic encephalopathy |
| Clinical information | M/27 C.C> seizure, semicoma |
| Discussion | Imaging findings - Diffusion restriction of the bilateral posterior limb of internal capsule with T2 hyperintensity - Diffusion restriction of the corpus callosum, splenium with T2 hyperintensity - No enhancement - Normal MR angiography, and no perfusion abnormality Review - Hypoglycemia is the sudden decrease in serum glucose level <50 mg/dL - The organ systems that manifest the signs and symptoms are the central and autonomic nervous system. - Mechanism - Metabolic alkalosis, ammonia formation, no lactic acidosis, increased aspartate, glutamate, excitotoxic edema - Location Bilateral, symmetric involvement White matter more sensitive - centrum semiovale, corona radiata, internal capsule, splenium of corpus callosum > cortex, basal ganglia Spare cerebellum, brainstem, thalamus due to greater activity of glucose transport mechanism, resistant in occipital cortex, dorsofrontal cortex, hippocampus than hypoxia - DWI is most sensitive to detect cytotoxic edema, can reversible |
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