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Cardiogenic cerebral embolism caused by a severe hypoglycemic attack : a case report
Hiroshi Koyama1,2,3, Mika Fujiwara4, Shinya Okita1
1Department of Neurosurgery, Takamatsu municipal hospital, Kagawa, Japan.
The Journal of Medical Investigation : JMI
|November 5, 2020
Summary
Severe hypoglycemia can trigger takotsubo syndrome, leading to cardiogenic cerebral embolism and stroke. This case highlights a rare but serious complication of low blood sugar.
Area of Science:
- Neurology
- Cardiology
- Endocrinology
Background:
- The direct link between hypoglycemic attacks and cerebral infarction is not well-established.
- Previous reports suggest hypoglycemic attacks can induce takotsubo syndrome, a potential cause of cerebral infarction.
Observation:
- A 71-year-old woman presented with severe hypoglycemia and subsequently developed hemiplegia.
- Brain imaging confirmed cerebral infarction in the left middle cerebral artery territory.
- Echocardiography indicated suspected takotsubo syndrome.
Findings:
- The patient was diagnosed with a cardiogenic cerebral embolism.
- The embolism was attributed to takotsubo syndrome, precipitated by the severe hypoglycemic attack.
Implications:
- This case underscores a rare but critical neurological complication of severe hypoglycemia.
- Recognizing this pathway is crucial for timely diagnosis and management of stroke in hypoglycemic patients.
- Further research may elucidate the mechanisms linking hypoglycemia, takotsubo syndrome, and embolic stroke.
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