당뇨병성 케톤산증과 함께 발생한 뇌경색으로 진단된 모야모야병 1례
Diabetic Ketoacidosis and Cerebral Infarction Leading to a Diagnosis of Moyamoya Disease
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초록
본 증례는 DKA로 내원한 제 1형 당뇨병 남아에서 뇌경색을 동반한 모야모야병이 진단된 경우이다. 제 1형 당뇨병 환자에서 지속적인 고혈당 및 DKA 상태에서 신경학적 증상과 함께 뇌허혈, 뇌경색이 동반되는 경우에 매우 드물지만 모야모야병의 가능성을 염두에 두어야 한다. 또한 모야모야병-제 1형 당뇨병이 병발된 경우 고혈당 및 DKA로 인해 뇌경색이 초래될 가능성이 있으므로 조기 수술적 치료와 함께 철저한 혈당 관리가 필요하겠다.
Abstract
There have been few reports of concomitant moyamoya disease (MMD) with type 1diabetes mellitus. We report a case of MMD associated with type 1 diabetes mellitus in a 9-year-old boy who presented with altered mentality and left side motor weakness. Laboratory test results indicated diabetic ketoacidosis (DKA), but his stuporous mental state and hemiparesis persisted despite DKA management. Brain magnetic resonance imaging revealed multiple cerebral infarcts and stenosis of cerebral arteries with basal collateral vessels, suggesting MMD. After management of DKA and successive surgery for MMD, his hemiparesis improved without further ischemic attacks. Although rare, the possibility of comcomitant MMD should be considered in a type 1 diabetes mellitus patient with neurologic symptoms and cerebral infarction.
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