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Specific changes in human brain after hypoglycemic injury

M Fujioka1, K Okuchi, K I Hiramatsu

  • 1Department of Neurosurgery, Nara Medical University, Japan. RXL00203@niftyserve.or.jp

Stroke
|March 1, 1997
PubMed
Summary

Severe hypoglycemia causes specific brain lesions in the basal ganglia, cerebral cortex, substantia nigra, and hippocampus. These findings highlight the vulnerability of these brain regions to hypoglycemic injury.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Endocrinology

Background:

  • Limited data exists on serial brain changes following severe hypoglycemic injury.
  • Hypoglycemic coma can lead to significant neurological deficits.

Purpose of the Study:

  • To investigate sequential neuroradiological changes in the brain after hypoglycemic coma.
  • To compare these changes with those observed after cardiac arrest.

Main Methods:

  • Repeated CT scans and 1.5 T MR imaging were performed.
  • Four vegetative patients with profound hypoglycemia due to diabetes mellitus were studied.

Main Results:

  • CT scans showed symmetrical, persistent low-density lesions with transient enhancement in basal ganglia and cerebral cortex.

Related Experiment Videos

  • MR imaging revealed persistent T1 hypointensity and T2 hyperintensity in basal ganglia, cerebral cortex, substantia nigra, and hippocampus.
  • Lesions were observed from 8 days to 12 months post-onset.

    • Conclusions:

    • Hypoglycemia selectively affects the basal ganglia, cerebral cortex, substantia nigra, and hippocampus.
    • Lesions likely represent tissue degeneration, including neuronal death and glial proliferation.
    • Absence of hemorrhages in hypoglycemic encephalopathy contrasts with post-anoxic injury.