Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia

Hyperdensity of basal ganglia in computed tomography (CT) of brain is alwaysrecognised as hemorrhagic stroke or calcification. Features of hyperglycemia include muscle weakness, hypotonia, pyramidal tract signs and hemichorea-hemiballismus (HC-HB), which mimic the symptoms of stroke. Hyperdensity...

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Main Authors: Ng, VH, Wan Nor Aida WMS, Ahmad Khaldun Ismail
Format: Article
Language:English
Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2018
Online Access:http://journalarticle.ukm.my/20630/
http://journalarticle.ukm.my/20630/1/29_ms0259_pdf_16881.pdf
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author Ng, VH
Wan Nor Aida WMS,
Ahmad Khaldun Ismail,
author_facet Ng, VH
Wan Nor Aida WMS,
Ahmad Khaldun Ismail,
author_sort Ng, VH
building UKM Institutional Repository
collection Online Access
description Hyperdensity of basal ganglia in computed tomography (CT) of brain is alwaysrecognised as hemorrhagic stroke or calcification. Features of hyperglycemia include muscle weakness, hypotonia, pyramidal tract signs and hemichorea-hemiballismus (HC-HB), which mimic the symptoms of stroke. Hyperdensity of the basal ganglia was reported in patient with non-ketotic hyperglycemia (NKH). Inability to recognize the hyperdensity in CT brain as a feature of NKH may lead to failure of treatment. Early recognition and reversal of hyperglycemia will improve the outcome. This was a case of an atypical presentation of stroke-like symptoms with the neuroimaging finding showing asymmetric hyperdensity of basal ganglia. Neurological examination failed to elicit any sign of HC-HB. Laboratory test showed hyperglycemia with absence of acidosis and ketonaemia. The patient was diagnosed having basal ganglia hemorrhage and referred to the Neurosurgical team. However, the stroke-like symptoms completely resolved following the normalization of glucose level. This is the only other reported case of NKH with typical neuroimaging features not associated with HC-HB. One should be aware of the possibility of NKH in the absence of movement disorder with asymmetric basal ganglia hyperdensity in CT brain. Misinterpretation as acute intracranial bleeding may result in suboptimal management of the true underlying cause.
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spelling oai:generic.eprints.org:206302022-11-28T13:19:22Z http://journalarticle.ukm.my/20630/ Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia Ng, VH Wan Nor Aida WMS, Ahmad Khaldun Ismail, Hyperdensity of basal ganglia in computed tomography (CT) of brain is alwaysrecognised as hemorrhagic stroke or calcification. Features of hyperglycemia include muscle weakness, hypotonia, pyramidal tract signs and hemichorea-hemiballismus (HC-HB), which mimic the symptoms of stroke. Hyperdensity of the basal ganglia was reported in patient with non-ketotic hyperglycemia (NKH). Inability to recognize the hyperdensity in CT brain as a feature of NKH may lead to failure of treatment. Early recognition and reversal of hyperglycemia will improve the outcome. This was a case of an atypical presentation of stroke-like symptoms with the neuroimaging finding showing asymmetric hyperdensity of basal ganglia. Neurological examination failed to elicit any sign of HC-HB. Laboratory test showed hyperglycemia with absence of acidosis and ketonaemia. The patient was diagnosed having basal ganglia hemorrhage and referred to the Neurosurgical team. However, the stroke-like symptoms completely resolved following the normalization of glucose level. This is the only other reported case of NKH with typical neuroimaging features not associated with HC-HB. One should be aware of the possibility of NKH in the absence of movement disorder with asymmetric basal ganglia hyperdensity in CT brain. Misinterpretation as acute intracranial bleeding may result in suboptimal management of the true underlying cause. Pusat Perubatan Universiti Kebangsaan Malaysia 2018-12 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/20630/1/29_ms0259_pdf_16881.pdf Ng, VH and Wan Nor Aida WMS, and Ahmad Khaldun Ismail, (2018) Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia. Medicine & Health, 13 (2). pp. 246-251. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/13/2
spellingShingle Ng, VH
Wan Nor Aida WMS,
Ahmad Khaldun Ismail,
Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title_full Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title_fullStr Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title_full_unstemmed Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title_short Basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
title_sort basal ganglia hyperdensity on computerised tomography of brain : a rare finding of non-ketotic hyperglycemia
url http://journalarticle.ukm.my/20630/
http://journalarticle.ukm.my/20630/
http://journalarticle.ukm.my/20630/1/29_ms0259_pdf_16881.pdf