Cases reported "Hyperglycemia"

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1/5. Non-ketotic hyperglycemia in a young woman, presenting as hemiballism-hemichorea.

    We report a 22-year-old girl presenting with acute onset left sided hemiballism-hemichorea (HH) and non-ketotic hyperglycemia (NKH). Initial brain CT revealed faint hyperdensities, sharply confined to the contralateral nucleus caudatus and putamen. Sequential MRI investigations yielded increasing hypersignal intensities on T1-weighted images and resolving hypodensities on T2-weighted images of the right striatum, leaving small sequelae in the head of the right caudate nucleus. NKH is an unusual cause of HH. The abnormalities seen in neuroimaging are rare, but seem to be quite specific to this syndrome. We give an update on current literature regarding the possible pathophysiological processes underlying this specific clinical entity.
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keywords = putamen
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2/5. Hemiballism with hyperglycemia and striatal T1-MRI hyperintensity: an autopsy report.

    We report on an autopsy findings of a 92-year-old male with hemiballism-hemichorea associated with hyperglycemia and striatal hyperintensity on T1-weighed magnetic resonance imaging (MRI), a recently described clinicoradiological syndrome. Histologically, the putamen contralateral to the hemiballism consisted of multiple foci of recent infarcts associated with reactive astrocytic and interneuronal response. Substrate responsible for the MRI signal changes is still inconclusive. copyright movement Disorder Society.
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keywords = putamen
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3/5. diffusion-weighted and gradient echo magnetic resonance findings of hemichorea-hemiballismus associated with diabetic hyperglycemia: a hyperviscosity syndrome?

    BACKGROUND: The magnetic resonance (MR) imaging findings of hemichorea-hemiballismus (HCHB) associated with hyperglycemia are characterized by hyperintensities in the striatum on T1-weighted MR images and computed tomographic scans, with a mechanism of petechial hemorrhage considered to be responsible. diffusion-weighted MR imaging (DWI) has been reported to detect early ischemic damage (cytotoxic edema) as bright areas of high signal intensity and vasogenic edema as areas of heterogeneous signal intensity. We report various DWI findings in 2 patients with hyperglycemic HCHB. OBJECTIVES: To describe the DWI and gradient echo findings and characterize the types of edema in HCHB associated with hyperglycemia. SETTING: A tertiary referral center neurology department. DESIGN AND methods: Two patients with HCHB associated with hyperglycemia underwent DWI, gradient echo imaging, and conventional MR imaging with gadolinium enhancement. The patients had an elevated serum glucose level on admission and a long history of uncontrolled diabetes, and the symptoms were controlled by dopamine receptor blocking agents. Initial DWIs were obtained 5 to 20 days after symptom onset. Apparent diffusion coefficient (ADC) values were measured in the abnormal lesions with visual inspection of DWI and T2-weighted echo planar images. RESULTS: T1- and T2-weighted MR images and brain computed tomographic scans showed high signal intensities in the right head of the caudate nucleus and the putamen. Gradient echo images were normal. The DWIs showed bright high signal intensity in the corresponding lesions (patient 1), and the ADC values were decreased. The decrease in ADC and the high signal intensity on DWI persisted despite the disappearance of HCHB, even after 70 days. CONCLUSIONS: Gradient echo MR imaging findings were normal in HCHB with hyperglycemia, whereas DWI and the ADC map showed restricted diffusion, which suggests that hyperviscosity, not petechial hemorrhage, with cytotoxic edema can cause the observed MR abnormalities.
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keywords = putamen
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4/5. Oro-bucco-lingual dyskinesia associated with nonketotic hyperglycaemia.

    Nonketotic hyperglycaemia is typically associated with a hemiballism-hemichorea pattern of involuntary movement and is characterized by hyperintense signal within the contralateral striatum on T(1)-weighted magnetic resonance imaging (MRI). An oro-bucco-lingual syndrome and location of the lesions has not been previously described. Herein, we report a patient with oro-bucco-lingual dyskinesia associated with nonketotic hyperglycaemia. MRI revealed characteristic T(1) hyperintense lesions in the bilateral putamen.
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5/5. Hyperintense putamen on T1-weighted MR images in a case of chorea with hyperglycemia.

    A 77-year-old woman had an acute onset of chorea after hyperglycemic coma. She had no family history of neurologic disorders. Although brain CT showed no detectable lesions in the putamen, MR revealed a high intensity on T1-weighted images and a low intensity on T2-weighted images in both putamina.
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ranking = 5
keywords = putamen
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