A case of diabetic ketoacidosis with posterior cerebral artery territory ischemic stroke mimicking uncal herniation
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In diabetic ketoacidosis, hyperglycemia and ketosis result in cerebral vasculitis, which can cause cerebral edema and thrombosis. A previously healthy, 12-year-old girl visited the emergency department with a history of vomiting, polydipsia, polyuria, decreased mentality, and a 7 kg (12%) weight loss within 1 week. She showed laboratory features of severe diabetic ketoacidosis, stuporous mentality, respiratory failure, and unilateral fixed mydriasis with contralateral hemiparesis. However, brain magnetic resonance imaging showed multifocal ischemic stroke mainly involving the left posterior cerebral artery territory, instead of uncal herniation. This case highlights the possible occurrence of ischemic stroke in children with early-stage diabetes mellitus.
Abstract
In diabetic ketoacidosis, hyperglycemia and ketosis result in cerebral vasculitis, which can cause cerebral edema and thrombosis. A previously healthy, 12-year-old girl visited the emergency department with a history of vomiting, polydipsia, polyuria, decreased mentality, and a 7 kg (12%) weight loss within 1 week. She showed laboratory features of severe diabetic ketoacidosis, stuporous mentality, respiratory failure, and unilateral fixed mydriasis with contralateral hemiparesis. However, brain magnetic resonance imaging showed multifocal ischemic stroke mainly involving the left posterior cerebral artery territory, instead of uncal herniation. This case highlights the possible occurrence of ischemic stroke in children with early-stage diabetes mellitus.
참고문헌 (11)
- Jain SK, "Hyperketonemia(ketosis), oxidative stress and type 1 diabetes", Pathophysiology, 13, pp.163~170 (2006)
- Romano M, "Endothelial perturbation in children and adolescents with type 1 diabetes : association with markers of the inflammatory reaction", Diabetes Care, 24, pp.1674~1678 (2001)
- Lawrence SE, "Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis", J Pediatr, 146, pp.688~692 (2005)
- Foster JR, "Diabetic KetoacidosisAssociated Stroke in Children and Youth", Stroke Res Treat, 2011, pp.219706~ (2011)
- Kuppermann N, "Clinical trial of fluid infusion rates for pediatric diabetic ketoacidosis", N Engl J Med, 378, pp.2275~2287 (2018)
- Lynch JK, "Report of the National Institute of Neurological Disorders and Stroke workshop on perinatal and childhood stroke", Pediatrics, 109, pp.116~123 (2002)
- Ho J, "Diabetic ketoacidosis and pediatric stroke", CMAJ, 172, pp.327~328 (2005)
- Rosenbloom AL, "Intracerebral crises during treatment of diabetic ketoacidosis", Diabetes Care, 13, pp.22~33 (1990)
- "Brain herniation" (2020)[URL]
- Shuayto MI, "Administration of intravenous tissue plasminogen activator in a pediatric patient with acute ischemic stroke", J Child Neurol, 21, pp.604~606 (2006)
- Roach ES, "Management of stroke in infants and children : a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young", Stroke, 39, pp.2644~2691 (2008)