Document Detail

Hyperglycemia Presenting as Left Middle Cerebral Artery Stroke: A Case Report.
MedLine Citation:
PMID:  25422707     Owner:  NLM     Status:  Publisher    
BACKGROUND AND PURPOSE: Hyperglycemia is an important diagnostic differential and has been reported to cause focal neurological deficits masquerading as stroke. Discussion of hyperglycemia as a stroke mimic has been sparse in the era of diffusion weighted imaging, but remains an important mimic.
CASE SUMMARY: A 67 year-old right-handed woman with presented with lethargy, global aphasia, left eye deviation and right hemiparesis. She received IV t-PA for left MCA syndrome and transferred for possible intervention. Initial labs showed a glucose 825mg/dL. MRI/MRA brain was negative for acute stroke with patent vessels, but abnormalities on MRperfusion. The patient was admitted and treated with medical resuscitation including IV fluids and an insulin drip. After normoglycemia was achieved the patient's neurological deficits resolved. EEG on day one of hospitalization showed left hemispheric slowing that subsequently normalized on continuous recording.
CONCLUSION: We report a case of hyperglycemia clinically mimicking a left MCA syndrome reversed with medical management possibly explained by metabolic demand-blood flow coupling of inactive tissue rather than hypoperfused tissue at risk of infarction.
Nirav H Shah; Victor Velez; Teresita Casanova; Sebastian Koch
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Publication Detail:
Journal Detail:
Title:  Journal of vascular and interventional neurology     Volume:  7     ISSN:  1941-5893     ISO Abbreviation:  J Vasc Interv Neurol     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-25     Completed Date:  -     Revised Date:  2014-11-26    
Medline Journal Info:
Nlm Unique ID:  101511381     Medline TA:  J Vasc Interv Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  9-12     Citation Subset:  -    
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