Journal
DIABETIC MEDICINE
Volume 22, Issue 8, Pages 1098-1100Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1464-5491.2005.01568.x
Keywords
hypoglycaemia; encephalopathy; MRI; laminar necrosis
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Background Laminar necrosis of the cerebral cortex characterized neuropathologically by delayed selective neuronal necrosis occurs in hypoglycaemic encephalopathy and other brain diseases. Case report A 37-year-old male with insulin-treated Type 1 diabetes mellitus developed hypoglycaemic encephalopathy associated with respiratory failure. Brain diffusion-weighted MRI during the subacute period demonstrated high signals along the cerebral cortex. Brain single-photon emission computed tomography showed diffuse, severe cerebral hypoperfusion. The patient remained comatose and died 1 month later. Conclusions High signals along the cortical bands on diffusion-weighted MRI suggest cortical laminar necrosis, although a postmortem examination was unavailable. Sustained hypoglycaemic brain injury, possibly associated with respiratory hypoxia, may be the underlying mechanism.
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