Localized reversible high signal intensities on diffusion-weighted MRI in hypoglycemia: A study of 70 cases.
BACKGROUND
It is well-known that localized reversible high signal intensities in the splenium of the corpus callosum or the basal ganglia appear on diffusion-weighted MRI in the presence of hypoglycemia. The aim of this study was to clarify the incidence and significance of such high signal intensity lesions.


RESULTS
We analyzed 70 cases of hypoglycemia with consciousness disturbance referred to our outpatient office. Localized reversible high signal intensities on diffusion-weighted MRI were noted in 6 cases (8.6%). They were at the splenium of the corpus callosum in four cases (5.7%), and right frontal cortex and bilateral frontal white matter in one each. Convulsions were noted in five cases, and right hemiparesis was noted in three. None of the three cases of hemiparesis showed localized reversible high signal intensities on diffusion-weighted MRI. These lesions are reversible if the patients undergo treatment without delay.


CONCLUSIONS
The significance of these lesions is still unclear. However, when a high signal intensity lesion that is not reasonable for the symptom is detected on diffusion-weighted MRI, an immediate check of the blood sugar level is mandatory.
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Masahito
M
Katoh
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Masami
M
Yoshino
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Takeshi
T
Aoki
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Takeo
T
Abumiya
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Hiroyuki
H
Imamura
Department of Neurosurgery, Hokkaido Neurosurgical Memorial Hospital, Sapporo, Japan.
Toshimitsu
T
Aida
Hypoglycemia; localized reversible high signal intensity; splenium of the corpus callosum
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