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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
PubMed

Insights

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.

Keywords:
cardiogenic cerebral embolismcerebral infarctionhypoglycemic attacktakotsubo cardiomyopathytakotsubo syndrome

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