Related Experiment Video

Updated: Aug 16, 2026

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
09:35

A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia

Published on: November 15, 2024

Acute hypertensive encephalopathy with widespread small-vessel disease at MRI in a diabetic patient: pathogenetic

F Cotton1, S Kamoun, F Rety-Jacob

  • 1Department of Radiology, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite Cedex, France.

Neuroradiology
|July 20, 2005
PubMed

Insights

This study details unusual magnetic resonance imaging (MRI) findings in a diabetic patient with uncontrolled hypertension and hyperglycemia, who experienced seizures and coma. The fatal outcome highlighted severe acute small-vessel disease impacting the brain.

Area of Science:

  • Neurology
  • Radiology
  • Endocrinology

Background:

  • Diabetes mellitus and hypertension are significant risk factors for cerebrovascular disease.
  • Hyperglycemia and uncontrolled hypertension can exacerbate small-vessel disease.
  • Magnetic resonance imaging (MRI) is crucial for diagnosing brain pathologies.

Observation:

  • A diabetic patient with neglected hypertension and hyperglycemia presented with seizures and coma.
  • The patient's outcome was fatal despite intensive medical care.
  • Unusual MRI findings were observed, indicating severe brain involvement.

Findings:

  • MRI revealed bilateral insular and temporo-occipital grey and white matter involvement.
  • Numerous, scattered, lacunar-like lesions were present in white matter, basal ganglia, and brainstem.
  • Lesions demonstrated a low apparent diffusion coefficient, with some showing contrast enhancement, suggestive of hypertensive encephalopathy and acute small-vessel disease.

Implications:

  • These findings underscore the severe neurological consequences of poorly managed diabetes, hypertension, and hyperglycemia.
  • The case highlights the diagnostic utility of advanced MRI techniques in identifying acute cerebrovascular changes.
  • Understanding the pathophysiology of such severe small-vessel disease is critical for potential therapeutic strategies.

More Related Videos

A Mouse Model for Vascular Cognitive Impairment and Dementia Based on Needle-guided Asymmetric Bilateral Common Carotid Artery Stenosis05:12

A Mouse Model for Vascular Cognitive Impairment and Dementia Based on Needle-guided Asymmetric Bilateral Common Carotid Artery Stenosis

Published on: November 22, 2024

Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Dementia l: Introduction01:22

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...