高血糖症脑损害的临床及影像学表现

Clinical manifestations and neuroimaging characteristics of cerebral damage in hyperglycemia

目的探讨血糖急剧增高所致脑损害的临床表现及影像学特征。方法对6例血糖急剧增高所致脑损害的临床表现及影像学特征进行回顾性分析。结果6例患者均为老年,急性发病,发病时血糖水平为21.9～43.2mmol/L,酮体检测阴性,临床表现为舞蹈症、癫痫、认知功能障碍等。CT显示为尾状核豆状核高密度影。MRI T_1WI呈高信号,T_2WI呈低信号。采用降低血糖治疗及对症症状好转。结论高血糖脑损害与其CT、MRI表现可能构成一临床综合征。

Objective To investigate the clinical manifestations and neuroimaging characteristics of cerebral damage in hyperglycemia with blood glucose acute increases. Methods The clinical manifestations and neuroimaging characteristics in 6 patients with hyperglycemia induced by cerebral damage were analyzed retrospectively. Results All of the 6 patients were aged and presenting an acute attack. The level of blood glucose at onset was 21. 9～43.2mmol/L,but ketone were negative. Clinical manifestations were hemichorea,epilepsy and cognitive dysfunction. The CT scaning showed high density signals in the caudate nucleus and putamen. MRI showed hyperintensity on T1-weighted images and hypointensity on T2-weighted images. Conclusion Hyperglycemia induced by cerebral damage and its CT and MRI manifestations could constitute a unique syndrome.