Choi Ju Young, Park Joon Min, Kim Kyung Hwan, Park Jun Seok, Shin Dong Wun, Kim Hoon, Jeon Woo Chan, Kim Hyun Jong
Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
Clin Exp Emerg Med. 2016 Dec 30;3(4):252-255. doi: 10.15441/ceem.15.035. eCollection 2016 Dec.
A 77-year-old woman was admitted to a local clinic for altered consciousness and presented with a suspected basal ganglion hemorrhage detected on brain computed tomography. The patient was stuporous, but her vital signs were stable. Her initial blood glucose was 607 mg/dL, and a hyperdense lesion was found in the right basal ganglion on brain computed tomography. T1-weighted magnetic resonance imaging revealed high signal intensity in the right basal ganglion. Electroencephalography showed no seizure activity. The patient was treated with a fluid infusion, and serum glucose level was controlled with insulin. The patient gradually recovered consciousness and was alert within 24 hours as serum glucose level normalized. The basal ganglion lesion caused by hyperglycemia was not accompanied by involuntary limb movement. This is the first report of a patient presenting with decreased consciousness and typical neural radiographic changes associated with nonketotic hyperglycemia but without movement abnormalities.
