Y Yoneda1, S Yamamoto. 1. Division of Neurology, Kobe Red Cross Hospital and Hyogo Emergency Medical Center, Kobe, Japan. y-yoneda@kobe.jrc.or.jp
Abstract
BACKGROUND: Laminar necrosis of the cerebral cortex characterized neuropathologically by delayed selective neuronal necrosis occurs in hypoglycaemic encephalopathy and other brain diseases. CASE REPORT: A 37-year-old male with insulin-treated Type 1 diabetes mellitus developed hypoglycaemic encephalopathy associated with respiratory failure. Brain diffusion-weighted MRI during the subacute period demonstrated high signals along the cerebral cortex. Brain single-photon emission computed tomography showed diffuse, severe cerebral hypoperfusion. The patient remained comatose and died 1 month later. CONCLUSIONS: High signals along the cortical bands on diffusion-weighted MRI suggest cortical laminar necrosis, although a postmortem examination was unavailable. Sustained hypoglycaemic brain injury, possibly associated with respiratory hypoxia, may be the underlying mechanism.
BACKGROUND: Laminar necrosis of the cerebral cortex characterized neuropathologically by delayed selective neuronal necrosis occurs in hypoglycaemic encephalopathy and other brain diseases. CASE REPORT: A 37-year-old male with insulin-treated Type 1 diabetes mellitus developed hypoglycaemic encephalopathy associated with respiratory failure. Brain diffusion-weighted MRI during the subacute period demonstrated high signals along the cerebral cortex. Brain single-photon emission computed tomography showed diffuse, severe cerebral hypoperfusion. The patient remained comatose and died 1 month later. CONCLUSIONS: High signals along the cortical bands on diffusion-weighted MRI suggest cortical laminar necrosis, although a postmortem examination was unavailable. Sustained hypoglycaemic brain injury, possibly associated with respiratory hypoxia, may be the underlying mechanism.
Authors: P Schmidt; J Böttcher; A Ragoschke-Schumm; H J Mentzel; G Wolf; U A Müller; W A Kaiser; T E Mayer; A Saemann Journal: AJNR Am J Neuroradiol Date: 2011-04-21 Impact factor: 3.825
Authors: Hanne M M Rooijackers; Evita C Wiegers; Cees J Tack; Marinette van der Graaf; Bastiaan E de Galan Journal: Cell Mol Life Sci Date: 2015-10-31 Impact factor: 9.261