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Cerebral venous thrombosis as a first presentation of diabetes

Marek J Sasiadek1, Dorota Sosnowska-Pacuszko, Marzena Zielinska

  • 1Department of Neuroradiology, Wroclaw Medical University, and Department of Radiology, T. Marciniak Memorial Hospital, Wroclaw, Poland. mareks@rad.am.wroc.pl

Pediatric Neurology
|August 1, 2006
PubMed

Insights

This rare case highlights cerebral venous thrombosis and infarction in a pediatric diabetic patient with hyperglycemia and ketoacidosis. Prompt imaging is crucial for diagnosing this severe complication.

Area of Science:

  • Neurology
  • Endocrinology
  • Pediatrics

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus.
  • Cerebral venous thrombosis (CVT) is a rare but potentially devastating neurological event.
  • The co-occurrence of DKA and CVT is exceptionally uncommon, particularly in pediatric patients.

Observation:

  • An 8-year-old male presented with symptoms of DKA, including hyperglycemia and ketoacidosis.
  • Within hours of admission, the patient developed altered consciousness.
  • Initial computed tomography (CT) revealed thrombosis in the vein of Galen and superior sagittal sinus with associated venous infarction.

Findings:

  • Follow-up CT confirmed the evolution of thrombosis.
  • Magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) definitively diagnosed CVT and venous infarction.
  • This represents the third reported case of CVT and venous infarction in a diabetic patient globally, and the second in a child.

Implications:

  • Hyperglycemia-induced hypercoagulability may contribute to CVT in diabetic patients.
  • This case underscores the importance of considering rare neurological complications in patients with DKA.
  • Advanced neuroimaging (CT, MRI, MRV) is vital for accurate diagnosis and management of CVT, even in atypical presentations.

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