Cerebral cortical laminar necrosis on diffusion-weighted MRI in hypoglycaemic encephalopathy.
BACKGROUND
Laminar necrosis of the cerebral cortex characterized neuropathologically by delayed selective neuronal necrosis occurs in hypoglycaemic encephalopathy and other brain diseases.


METHODS
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.
Yoneda
Y
Y
Division of Neurology, Kobe Red Cross Hospital and Hyogo Emergency Medical Center, Kobe, Japan. y-yoneda@kobe.jrc.or.jp
Yamamoto
S
S
D000328:Adult; D001928:Brain Diseases, Metabolic / Q000175:diagnosis / Q000209:etiology*; D002540:Cerebral Cortex / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D017809:Fatal Outcome; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000473:pathology; D008297:Male; D009336:Necrosis