-
[show abstract]
[hide abstract]
ABSTRACT: Purpose: Reports of serial magnetic resonance imaging (MRI) in hypoglycemic encephalopathy were limited because MRI is not routinely performed in these patients. Here we present one patient with a history of hypoglycemic encephalopathy and discuss sequential neuroimaging findings. Case Report: A 53-year-old male mistakenly took oral hypoglycemic agents developed hypoglycemic encephalopathy. Immediate brain diffusion-weighted image (DWI) demonstrated extensive symmetrical hyperintensive lesions over bilateral subcortical white matter. 14 days later, new hyperintensive lesions involving bilateral cerebral cortex were found on DWI, while previous subcortical white matter lesions disappeared. On day 86, diffusion-weighted images abnormalities vanished and diffuse brain atrophy was noted. Conclusion: Although subcortical white matter involvement in hypoglycemic encephalopathy was occasionally reported in the literature, few report revealed similar serial MRI changes as our case. Although its mechanism is still unknown, it is important to follow sequential images in hypoglycemic encephalopathy. The brain tissue which was normal in early DWI may not necessarily guarantee undamaged.
Acta neurologica Taiwanica 03/2013; 22(1):22-5.
-
The American journal of emergency medicine 02/2012; · 1.54 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Spinal epidural hematoma is an accumulation of blood in the epidural space that can mechanically compress the spinal cord. It is an uncommon condition, and most cases occur spontaneously. Detailed evaluation of neurologic deficit and detailed history taking are important tools for early diagnosis, and magnetic resonance imaging is currently the diagnostic method of choice. Prompt surgical intervention is important in achieving positive clinical outcomes. Spinal epidural hematoma usually comes with acute, severe pain with radiation to the extremities and may be accompanied with severe neurologic deficit. Common neurologic signs include paraparesis and quadriparesis. Here, we report 2 cases of cervical spinal epidural hematoma with sudden onset of neck pain, followed by the development of unilateral limbs weakness and respiratory distress. Both patients were initially suspected to have acute ischemic stroke and were considered using intravenous thrombolytic therapy with recombinant tissue plasminogen activator as treatment. Cervical spinal epidural hematoma was confirmed after obtaining magnetic resonance imaging. Patients with this uncommon presentation must be carefully distinguished from acute stroke. This article aimed to highlight the potential pitfalls in diagnosing acute hemiparesis with no cranial nerves deficits and the importance of clinical suspicion.
The American journal of emergency medicine 08/2011; 30(7):1322.e1-3. · 1.54 Impact Factor
