저혈당으로 촉발된 허혈성 뇌졸중1예
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Hypoglycemia rarely presents with a focal neurological deficit, which could be misdiagnosed as a transient ischemic attack or stroke unless the condition is detected and corrected promptly. The mechanism of a focal neurological deficit in severe hypoglycemia has not been well established yet. We report a 58-year-old diabetic woman presenting with speech disturbance and hypoglycemia. Her MRA and TCD revealed nearly occlusive stenosis at the M1 proximal portion of the left MCA. Her neurological deficit did not reverse in spite of early diagnosis and management of hypoglycemia, leaving a high signal intensity in the left parietal cortex on T2 weighted MRI. We suggest that hypoglycemia may cause hemodynamic redistribution, which subsequently precipitate an ischemic stroke in a patient with pre-existing cerebrovascular compromise. Korean Journal of Stroke 2002;4(2):154~158
Abstract
Hypoglycemia rarely presents with a focal neurological deficit, which could be misdiagnosed as a transient ischemic attack or stroke unless the condition is detected and corrected promptly. The mechanism of a focal neurological deficit in severe hypoglycemia has not been well established yet. We report a 58-year-old diabetic woman presenting with speech disturbance and hypoglycemia. Her MRA and TCD revealed nearly occlusive stenosis at the M1 proximal portion of the left MCA. Her neurological deficit did not reverse in spite of early diagnosis and management of hypoglycemia, leaving a high signal intensity in the left parietal cortex on T2 weighted MRI. We suggest that hypoglycemia may cause hemodynamic redistribution, which subsequently precipitate an ischemic stroke in a patient with pre-existing cerebrovascular compromise. Korean Journal of Stroke 2002;4(2):154~158