title: Unilateral putaminal CT, MR, and diffusion abnormalities secondary to nonketotic hyperglycemia in the setting of acute neurologic symptoms mimicking stroke.
abstract: A 75-year-old Asian man presented with two episodes of chorea associated with nonketotic hyperglycemia. His chorea rapidly resolved after restitution of a normal serum glucose level, although an MR image obtained at the time of acute symptoms demonstrated high signal intensity on T1-weighted images, low signal intensity on T2-weighted images, and restricted diffusion, all involving the left putamen. A CT scan obtained 1 month later demonstrated faint hyperattenuation of the involved putamen. The reported pathophysiologic considerations for these imaging features are reviewed, and an original explanation is proposed.
authors.affiliation: Department of Radiology, Neuroradiology Section, University of California, San Francisco, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: Pratik
authors.initials: P
authors.lastname: Mukherjee
authors.forename: Esther L
authors.initials: EL
authors.lastname: Yuh
authors.forename: William P
authors.initials: WP
authors.lastname: Dillon
mesh_terms: D000368:Aged; D002819:Chorea / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D020158:Hyperglycinemia, Nonketotic / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D011699:Putamen / Q000000981:diagnostic imaging* / Q000473:pathology*; D020521:Stroke / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed