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(Stroke. 2005;36:e20.)
© 2005 American Heart Association, Inc.

Case Report

Localized Reversible Reduction of Apparent Diffusion Coefficient in Transient Hypoglycemia-Induced Hemiparesis

J. Böttcher, MD; A. Kunze, MD; C. Kurrat, MD; P. Schmidt, MD; G. Hagemann, MD; O.W. Witte, MD W.A. Kaiser, MD, MS

From the Department of Diagnostic and Interventional Radiology (J.B., C.K., P.S., W.A.K.), and Department of Neurology (A.K., G.H., O.W.W.), Friedrich-Schiller-University Jena, Germany.

Correspondence to Dr Joachim Böttcher, Department of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, 07747 Jena, Germany. E-mail joachim.boettcher{at}med.uni-jena.de

Background and Purpose— The pathophysiology of hypoglycemia shares a common mechanism with cerebral ischemia, but so far, little is known regarding MRI of humans with hypoglycemia.

Methods— We report a patient with left hemiparesis and dysarthria associated with a blood glucose level of 1.7 mmol/L. The patient recovered completely after glucose infusion.

Results— The initial diffusion-weighted imaging (DWI) showed increased signal intensities and a reduction of apparent diffusion coefficient (ADC) values localized in the corpus callosum (splenium) and asymmetrically in the corona radiata. After 48 hours, follow-up revealed complete recovery of DWI and ADC signal abnormalities.

Conclusion— To our knowledge, this is the first presentation of a case with transient hypoglycemia-induced focal neurological deficits revealing completely reversible MRI changes in terms of disturbed DWI and ADC with a peculiar as yet undescribed topography.

Key Words: apparent diffusion coefficient • diffusion-weighted imaging • hypoglycemia • magnetic resonance imaging

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