Cerebral injury in association with profound iatrogenic hyperglycemia in a neonate.
The adverse effect of hyperglycemia on neurological outcome following cerebral ischemia has been established in both experimental and adult human studies. However, there is a paucity of data to assess this risk in the human infant. This case is the first to describe severe and prolonged iatrogenic hyperglycemia in association with ischemia in an infant who sustained a major cerebral lesion. The topography of the predominant cerebral injury, i.e., bilateral parieto-occipital cortex and subcortical white matter, shown by magnetic resonance imaging was similar to that documented in the hypoglycemic infant, suggesting a similarity in regional cerebral vulnerability to altered glucose metabolism. This case extends recognition of the risk of severe hyperglycemia in association with cerebral ischemia to the newborn and suggests also that the posterior cerebral predilection for injury is similar in both hypoglycemia and hyperglycemia.
Efron
Daryl
D
Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia.
South
Mike
M
Volpe
Joseph J
JJ
Inder
Terrie
T
D001284:Atrophy / Q000473:pathology; D001479:Basal Ganglia / Q000473:pathology; D002545:Brain Ischemia / Q000209:etiology* / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology; D062787:Drug Overdose; D004569:Electroencephalography; D005947:Glucose / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007049:Iatrogenic Disease; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D009336:Necrosis; D009778:Occipital Lobe / Q000473:pathology; D012640:Seizures / Q000175:diagnosis
D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose