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[Transient cerebral oedema associated to hypoglycaemia].
A Berbel-García1, J Porta-Etessam, A Martínez-Salio
1Servicio de Neurología, Hospital Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain. aberbel@yahoo.com
Revista De Neurologia
|December 15, 2004
Summary
Severe hypoglycemia in adults can cause brain edema, similar to findings in neonates. Prompt treatment with glucose and mannitol led to full recovery in a 45-year-old woman after insulin overdose.
Area of Science:
- Neurology
- Endocrinology
- Radiology
Background:
- Hypoglycemia, or low blood glucose, is common in neonates but rarely symptomatic.
- In adults, hypoglycemia is typically linked to insulin or oral hypoglycemic agent overdose.
- Few reports detail hypoglycemic injury in adults, especially with favorable outcomes.
Observation:
- A 45-year-old woman presented with coma due to insulin overdose.
- Her glucose level was critically low (15 mg%).
- Brain imaging revealed significant edema, particularly in the parieto-occipital lobes.
Findings:
- Acute hypoglycemia can induce brain edema, affecting specific brain regions.
- Similar parieto-occipital edema is observed in neonatal hypoglycemia.
- Adults may experience lesions in the hippocampus and basal ganglia, with unclear reasons for regional sensitivity.
Implications:
- Prompt treatment of severe hypoglycemia with glucose and mannitol can lead to complete functional recovery.
- Understanding regional brain vulnerability in hypoglycemia is crucial for predicting long-term sequelae.
- Hypoglycemia-induced brain edema highlights the importance of rapid glucose level normalization to prevent neurological damage.