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Cerebral Accidents in Pediatric Diabetic Ketoacidosis: Different Complications and Different Evolutions

Enza Mozzillo1, Alessandra D'Amico, Valentina Fattorusso

  • 1Section of Pediatrics, Department of Translational Medical Science, Regional Center of Pediatric Diabetology, University of Naples Federico II, Naples, Italy.

Hormone Research in Paediatrics
|July 4, 2015
PubMed

Insights

Diabetic ketoacidosis (DKA) can cause serious brain complications like cerebral edema and stroke, even with proper treatment. Early and accurate DKA management is crucial, especially in children, to prevent these neurological risks.

Area of Science:

  • Neurology
  • Endocrinology
  • Metabolic Disorders

Background:

  • Diabetic ketoacidosis (DKA) is a serious complication of diabetes.
  • Neurologic complications, including cerebral edema and stroke, are known risks associated with DKA.
  • The link between DKA, hypercoagulability, and stroke risk is often underestimated.

Observation:

  • This study presents three cases of cerebral accidents occurring during or after DKA.
  • Cases included diffuse cerebral edema, venous stroke post-DKA resolution, and multifocal edema (suspected extrapontine myelinolysis).
  • One case of suspected extrapontine myelinolysis occurred without electrolyte imbalance.

Findings:

  • DKA is associated with a spectrum of neurological complications, including stroke and cerebral edema.
  • Cerebral complications can occur even with appropriate medical management of DKA.
  • The risk of stroke in DKA patients, particularly younger individuals, may be underestimated.

Implications:

  • Accurate and timely treatment of DKA is essential, especially in pediatric patients.
  • Clinicians should maintain a high index of suspicion for neurologic complications in patients with DKA.
  • Further research is needed to fully elucidate the pathogenetic mechanisms linking DKA and cerebrovascular events.

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