Diabetic Striatopathy Complicated With Acute Ischemic Stroke: A Case Report

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Diabetic striatopathy (DS) is a rare complication of hyperglycemia characterized by choreiform movements and reversible striatal abnormalities.
• The simultaneous occurrence of DS and acute ischemic stroke (AIS) in the striatum has not been previously reported.

Observation:

• A 68-year-old male with uncontrolled type 2 diabetes presented with progressive involuntary movements.
• Initial MRI suggested AIS with hemorrhage, but persistent symptoms and CT findings indicated both DS and AIS.
• The patient's symptoms resolved with glucose control, but neuroimaging showed evolving striatal changes.

Findings:

• This case demonstrates the simultaneous occurrence of DS and AIS in the striatum.
• DS and AIS can be misdiagnosed as AIS with hemorrhage based on initial neuroimaging.
• Successful glucose control led to symptom remission and resolution of certain imaging abnormalities over time.

Implications:

• Clinicians should consider the possibility of coexisting DS and AIS in diabetic patients with striatal symptoms and hyperglycemia.
• Accurate differentiation is crucial to avoid misdiagnosis and ensure timely, appropriate treatment.
• This highlights the complex interplay between hyperglycemia, cerebrovascular events, and basal ganglia dysfunction.