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NEURORADIOLOGY Table of Contents   
Year : 2006  |  Volume : 16  |  Issue : 2  |  Page : 183-184
CT imaging of neonatal hypoglycemia - A case report


Department of Radiodiagnosis, Medical College Hospital, Trivandrum 695011, Kerala, India

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Keywords: Neonatal hypoglycemia, CT

How to cite this article:
Balaji R, Verghese J, Chacko S A. CT imaging of neonatal hypoglycemia - A case report. Indian J Radiol Imaging 2006;16:183-4

How to cite this URL:
Balaji R, Verghese J, Chacko S A. CT imaging of neonatal hypoglycemia - A case report. Indian J Radiol Imaging [serial online] 2006 [cited 2019 Nov 14];16:183-4. Available from: http://www.ijri.org/text.asp?2006/16/2/183/29084
A 6-day old infant was admitted to our hospital with seizures, irritability and poor feeding. CT imaging of the brain showed edema and parenchymal loss typically confined to the occipital and parietal lobes of the brain. Though hypoglycemia is a common occurrence in neonates hours or days after birth, there are only few cases of brain damage from neonatal hypoglycemia reported in the literature. This case report contains the clinical and neuroimaging features of a case of brain damage resulting from hypoglycemia in a neonate.


   Case Report Top


A 6-day old term infant born to a non-diabetic mother was admitted to our hospital with, seizures, irritability and poor feeding. The infant's Apgar score was 8 at 1 minute and 9 at 5 minutes and weighed 3100 g. Blood glucose level in this neonate was 6.0 mg/dl at time of admission. A term infant is considered to be hypoglycemic if his/her blood glucose concentration is less than 30 mg/dl. Etiological investigations for hypoglycemia were normal.

CT study of the brain revealed edema and multiple hypodense areas resembling infarctions involving both the cortex and underlying white matter, but restricted to the occipital and parietal lobes. CT images also demonstrated parenchymal loss of occipital lobes as evidenced by the prominence of the occipital horns of both lateral ventricles. The basal ganglia, temporal and frontal lobes were spared.


   Discussion Top


The imaging studies and clinical records of a series of neonatal hypoglycemia patients with brain injury revealed that both the cortices and underlying white matter were affected and these changes were typically confined to the parietal and occipital lobes [1],[2].The pathological changes of neonatal hypoglycemia confirm the brain damage due to neonatal hypoglycemia was localized mainly in the parietal and occipital lobes [3],[4].Our findings of diffuse brain damage observed using CT imaging resembles closely with the observations reported by Anderson etal[3],[4], Spar et al[2] and Barkovich et al [1] with regard to the diffuse nature of neonatal hypoglycemic injury and also localization of injured regions to the parietaland occipital cortices. There is no explanation for the vulnerability of these regions .No correlation can be made with the normal glucose uptake in hypoglycemic neonates since the glucose demand of these regions as determined by Positron Emission Tomography is relatively low [5].

Thus the CT imaging findings of edema and multiple hypodense areas involving the occipital and parietal cortices predominantly with parenchymal loss appear to be relatively specific for neonatal hypoglycemia.

 
   References Top

1.Barkovich AJ, Ali FA, Rowley HA, Bass N (1998) Imaging Patterns of Neonatal Hypoglycemia AJNR 19:523-528  Back to cited text no. 1    
2.Spar JA, Lewine JD, Orrison WW Jr (1993) Neonatal Hypoglycemia: CT and MR Findings AJNR 15:1477-1478  Back to cited text no. 2    
3.Anderson HA, Milner R, Strich S. Pathological changes in the nervous system in severe neonatal hypoglycemia.Lancet 1966:2:372-375.  Back to cited text no. 3    
4.Anderson JM,Milner RDG,Strich S. Effects of neonatal hypoglycemia on the nervous system:a pathological study. J Neurosurg Psychiatry 1967; 30:295-310.  Back to cited text no. 4    
5.Chugani HT, Phelps ME, Mazziotta JC (1987) Positron Emission Tomography Study of Human Brain Functional Development Ann.Neurol 22:487-497  Back to cited text no. 5    

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Correspondence Address:
R Balaji
Division of Imageology, Regional Cancer Centre, Trivandrum 695011
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.29084

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[Figure - 1], [Figure - 2]



 

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