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Sartor-Pfeiffer, J.* ; Lingel, M.* ; Stefanou, M.I.* ; Lindig, T.* ; Bender, B.* ; Poli, S.* ; Ziemann, U.* ; Fritsche, A. ; Feil, K.* ; Mengel, A.*

Regional computed tomography perfusion deficits in patients with hypoglycemia: Two case reports.

Neurol. Res. Pract. 4:36 (2022)
Publ. Version/Full Text DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
BACKGROUND: Hypoglycemia in patients with diabetes mellitus, particularly type 1 can mimic acute ischemic stroke by causing focal neurological deficits. In acute ischemic stroke, the interpretation of emergency imaging including computed tomography with angiography and perfusion is crucial to guide revascularizing therapy including intravenous thrombolysis. However, different metabolic abnormalities and stroke mimics can cause focal hypoperfusion. METHODS: We describe two type 1 diabetes patients presenting with acute focal neurological deficits and hypoglycemia, who underwent multimodal computed tomography and follow-up imaging. CASE PRESENTATION: Patient 1, a 20-year-old man presented with aphasia and interstitial glucose level of 54 mg/dl. Patient 2, a 77-year-old man presented with aphasia, mild right-sided brachiofacial paresis and interstitial glucose level of 83 mg/dl. On brain imaging, no acute infarct signs were noted. Yet, both had focal left hemispheric cerebral hypoperfusion without large-vessel occlusion or stenosis. Due to persistent symptoms after normalization of blood glucose and despite a perfusion imaging pattern that was interpretated as non-typical for ischemia, both patients underwent thrombolysis without any complications. CONCLUSION: Computed tomography perfusion might help to discriminate hypoglycemia with focal neurological signs from acute stroke, but further evidence is needed.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Case Report ; Computed Tomography Perfusion ; Hypoglycemia ; Hypoperfusion ; Ischemic Stroke ; Stroke Mimic ; Type 1 Diabetes Mellitus
ISSN (print) / ISBN 2524-3489
e-ISSN 2524-3489
Journal Neurological Research and Practice
Quellenangaben Volume: 4, Issue: 1, Pages: , Article Number: 36 Supplement: ,
Publisher BMC
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)