Hyperosmolar Hyperglycemic State-Induced Hyperviscosity as a Catalyst for Multiple Embolic Strokes

Area of Science:

• Endocrinology
• Neurology
• Vascular Medicine

Background:

• Hyperosmolar hyperglycemic state (HHS) is a critical complication of uncontrolled diabetes mellitus.
• HHS is associated with a prothrombotic state, elevating ischemic risk.
• Limited data exists on stroke risk during acute hyperglycemic crises.

Observation:

• An 86-year-old male presented with HHS.
• The patient experienced multiple embolic strokes during hospitalization for HHS.
• Cerebral infarction in the context of HHS poses diagnostic challenges.

Findings:

• This case illustrates a rare instance of multiple embolic strokes occurring during a hyperglycemic crisis.
• Clinical vigilance is crucial for identifying cerebral infarction in patients with HHS.
• The prothrombotic mechanisms underlying HHS-related stroke require further investigation.

Implications:

• Highlights the need for heightened awareness of cerebrovascular events in HHS patients.
• Underscores the importance of early diagnosis and management of stroke in hyperglycemic crises.
• Suggests further research into the prothrombotic pathophysiology of HHS.