Diabetic Striatopathy Following Radiological Improvement: An Autopsy-confirmed Case Report and Literature Review

Area of Science:

• Neurology
• Endocrinology
• Pathology

Background:

• Diabetic striatopathy (DS) is a rare neurological complication linked to poorly controlled diabetes mellitus.
• Its pathogenesis is hypothesized to involve microvascular injury, but autopsy evidence is limited.
• Hemichorea is a potential manifestation of DS.

Purpose of the Study:

• To provide autopsy-based histological documentation of diabetic striatopathy.
• To investigate the pathological changes in a case of DS with hemichorea.
• To correlate radiological findings with histological outcomes.

Main Methods:

• Autopsy of a patient with diabetic striatopathy and hemichorea.
• Histological examination of the basal ganglia and cerebellum.
• Correlation of imaging findings with pathological results.

Main Results:

• Autopsy confirmed diabetic striatopathy with neuronal loss, astrocytosis, calcification, and organizing hemorrhage in the basal ganglia.
• The patient presented with hemichorea despite radiological improvement.
• Histological findings indicated irreversible structural damage within 82 days post-imaging.

Conclusions:

• Diabetic striatopathy can lead to irreversible pathological injury even when radiological findings normalize.
• DS represents a spectrum of neurological damage, from functional disturbance to structural injury.
• Autopsy confirmation is crucial for understanding the long-term pathology of DS.