title: Case report: hypoglycemia and diffusion-weighted imaging.
abstract: The effect of severe hypoglycemia on the brain is well known, ranging from alterations of mental status to profound coma and death. We describe a case of global diffusion abnormalities eventually resulting in death. This otherwise healthy patient presented with seizures and a serum glucose level less than 20 mg/dL. Testing suggested that the hypoglycemia was likely caused by exogenous insulin or perhaps insulin receptor antibodies. Magnetic resonance imaging on the day after admission showed regions of restricted diffusion in the temporal and occipital lobes as well as in the basal ganglia. Despite the large body of literature concerning the pathophysiology of hypoglycemia and its clinical implications, little is known regarding its radiologic correlations.
authors.affiliation: Department of Radiology, New England Medical Center, and the Tusfts university School of Medicine, Boston, MA 02111, USA.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Chan
authors.forename: Sami
authors.initials: S
authors.lastname: Erbay
authors.forename: Stephen
authors.initials: S
authors.lastname: Oljeski
authors.forename: David
authors.initials: D
authors.lastname: Thaler
authors.forename: Rafeeque
authors.initials: R
authors.lastname: Bhadelia
mesh_terms: D001921:Brain / Q000473:pathology*; D002560:Cerebrovascular Circulation; D003128:Coma / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000209:etiology