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文献名称

低血糖昏迷中低血糖对脑血流量的影响 [下载]
 
The infl uence of hypoglycemia on cerebral blood fl ow in cases of hypoglycemic coma
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文献简介

出版社:Neurology India

作者:Yuzo Terakawa, Naohiro Tsuyuguchi, Akinori Yamamura1 , Toshio Nakagawa

编号:10.4103/0028-3886.48814

关键字:Cerebral blood flow, diffusion-weighted imaging, hypoglycemia, hypoglycemic coma, single photon emission computed tomography

年份:2009点击量:499

文献摘要

          The authors report two cases of hypoglycemic coma in which both diffusion-weighted imaging (DWI) and single photon emission computed tomography (SPECT) were used. A 74-year-old woman (case 1) presented with deep coma associated with hypoglycemia (blood glucose level: 20 mg/dl), and DWI on admission revealed extensive hyperintensity lesions. SPECT obtained on the second hospital day revealed diffuse hyperperfusion and a follow-up SPECT on the eighth hospital day showed relative hypoperfusion. An 89- year- old woman (case 2) presented with coma associated with hypoglycemia (blood glucose level: 45 mg/dl), and DWI showed diffuse hyperintensity lesions in both hemispheres. SPECT obtained on the ninth hospital day showed relative hypoperfusion compared to the first scan obtained on the third hospital day. Although the blood glucose level was rapidly corrected, the level of consciousness remained unchanged in both cases. Our results suggest that cerebral blood flow may increase even after glucose correction and that relative hypoperfusion could occur in the subacute stage of hypoglycemic coma.

        本文报告了2例使用弥散加权成像(DWI)和单光子发射计算体层摄影(SPECT)的低血糖昏迷病例。案例1为一位由低血糖引起深昏迷症状的74岁女性(血糖水平:20 mg/dl),住院时进行DWI发现广泛性高信号病变。住院第二天,SPECT显示弥漫性过度灌注,而住院第八天SPECT随访显示相对性灌注不足。案例2为一位出现低血糖性昏迷症状的89岁老年女性(血糖水平:45 mg/dl),的DWI显示两半球弥漫性高信号病变。与住院第三天的第一次扫描相比,住院第九天的SPECT显示相对性灌注不足。尽管迅速纠正了血糖水平,但在这两例病例中,她们的意识水平仍无变化。本研究结果表明,在低血糖昏迷的亚急性期间,甚至是葡萄糖校正后脑血流量也可能会增加,并且可能发生相对性灌注不足。

 

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