Open AccessBilateral Putaminal Hemorrhage with Cerebral Edema in Hyperglycemic Hyperosmolar Syndrome
Author(s) -
SooJin Cho,
Tae Kyoung Won,
Seung Ju Hwang,
Joong Hyuck Kwon
Publication year - 2002
Publication title -
yonsei medical journal/yonsei medical journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.702
H-Index - 63
eISSN - 1976-2437
pISSN - 0513-5796
DOI - 10.3349/ymj.2002.43.4.533
Subject(s) - medicine , ketonuria , cerebral edema , diabetes mellitus , diabetic coma , diabetic ketoacidosis , coma (optics) , intracerebral hemorrhage , edema , midline shift , anesthesia , brain edema , brain herniation , type 2 diabetes mellitus , blood pressure , blood sugar , surgery , subarachnoid hemorrhage , hematoma , endocrinology , physics , optics
Bilateral putaminal hemorrhages rarely occur simultaneously in hypertensive patients. The association of intracerebral hemorrhage with cerebral edema (CE) has been rarely reported in diabetic patients. We present a patient with bilateral putaminal hemorrhage (BPH) and CE during the course of hyperglycemic hyperosmolar syndrome (HHS). A 40-year-old man with a history of diabetes mellitus and chronic alcoholism was admitted with acute impaired mentality. His blood pressure was within the normal range on admission. Laboratory results revealed hyperglycemia and severe metabolic acidosis without ketonuria. After aggressive treatment, plasma sugar fell to 217 mg/dl, but brain CT showed BPH and diffuse CE. Our case demonstrated that HHS should be considered as a cause of BPH with CE. Initial brain imaging study may be recommended for patients with diabetic coma.