
Severe Hypoglycemia and Vulnerability of the Brain
Arch Neurol. 2006;63:138.
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An 82-year-old woman presented to the emergency department with altered mental status. Her son had conversed with her by telephone 36 hours before the onset, but he could not reach her by telephone 24 hours after that. She had a medical history of right hemiparesis and dysarthria 14 years earlier and had been taking medication for hypertension as well as aspirin. She was diagnosed as having type 1 diabetes mellitus and began taking medication for her diabetes 1 month prior to this onset. Her blood glucose level during the emergency department visit was 12 mg/dL (0.7 mmol/L). Her initial blood pressure was 173/76 mm Hg and oxygen saturation was 91.3%. Diffusion-weighted magnetic resonance (MR) imaging and T2-weighted MR imaging showed diffuse cortical high signal (Figure). The brainstem, cerebellum, and thalamus were spared.1 Despite prolonged hypoglycemia, the dorsofrontal cortex and occipital poles were also spared. The signal changes on . . . [Full Text of this Article]AUTHOR INFORMATION
Soo-Jin Cho, MD;
Yang-Ki Minn, MD;
Ki-Han Kwon, MD
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