Reversible splenial abnormality in hypoglycemic encephalopathy.
BACKGROUND
Lesions involving the splenium of the corpus callosum (SCC) have been rarely reported in cases of hypoglycemic brain injury.


METHODS
We identified signal abnormalities in the SCC in three adult patients with hypoglycemic encephalopathy by using diffusion-weighted imaging (DWI) on a 1.5-T MR scanner. Repeat DWI was performed in all patients following a marked clinical improvement, and MR angiography and routine MRI were also performed. We examined each patient's detailed medical history and blood laboratory tests in order to exclude other conditions causing similar SCC abnormalities.


RESULTS
Initial DWI was performed during which each patient showed altered mental status that was attributed to profound hypoglycemia. We observed an identical pattern of DWI abnormality characterized by high signals in the SCC with apparent diffusion coefficient reductions that were reversed completely within several days following appropriate correction of hypoglycemia. T2-weighted or FLAIR images also showed no residual lesion in the SCC and MR angiography was normal in all patients.


CONCLUSIONS
These case reports suggest that the SCC should be added to the list of selective vulnerability to hypoglycemia and that hypoglycemia, in turn, be included in the differential diagnosis of reversible SCC abnormalities.
Kim
Ji Hyun
JH
Department of Neurology, Guro Hospital, Korea University School of Medicine, 80 Guro-Dong, Guro-Ku, Seoul, 152-703, South Korea. jhkim.merrf@gmail.com
Choi
Jeong Yoon
JY
Koh
Seong-Beom
SB
Lee
Younghen
Y
D000328:Adult; D000368:Aged; D001928:Brain Diseases, Metabolic / Q000209:etiology* / Q000473:pathology*; D003337:Corpus Callosum / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications* / Q000188:drug therapy; D008297:Male