ACUTE TOMOGRAPHIC CHANGES OF METABOLIC ORIGIN MIMICKING BASAL GANGLIA HEMORRHAGE, CASE REPORT

Abstract

Patients with acute neurological changes, especially with focal neurological deficit, require images for its initial approach,generally skull tomography due to its availability.Here we report a case of an 80-year-old patient with altered state of consciousness and a seizure episode who was admitted on suspicion of cerebral hemorrhage. Her initial blood glucose was high and a hyperdense lesion was found in the right basal ganglion on brain computed tomography, laboratories in which no other metabolic alteration was identified apart from the acute decompensation of Diabetes, however, with a neuroradiology and clinical team, the diagnosis of diabetic striatopathy was made. The patient was treated with a fluid infusion, and serum glucose level was controlled with insulin. The patient gradually recovered consciousness and was alert to his baseline state within 24 hours,without neurological complications. Patients with risk factors and with findings suggesting stroke,the tomographic high densities,may suggest intracerebral hemorrhage;however,other metabolic and toxic pathologies may have similar tomographic changes. Our intention,is show to emergency physicians the presence of ganglio basal hyperintensities,mimics for gangliobasal hemorrhage should be studied according to history and clinical context and establish appropriate treatment in a timely manner.