Yonsei Med J.  2002 Aug;43(4):533-535. 10.3349/ymj.2002.43.4.533.

Bilateral Putaminal Hemorrhage with Cerebral Edema in Hyperglycemic Hyperosmolar Syndrome

• Cho SJ
• Won TK
• Hwang SJ
• Kwon JH

• KMID: 1122013
• DOI: http://doi.org/10.3349/ymj.2002.43.4.533

Abstract

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.

Keyword

Diabetic coma; hyperglycemic hyperosmolar syndrome; cerebral edema; putaminal hemorrhage; intracerebral hemorrhage

MeSH Terms

Adult
Brain/pathology
Brain Edema/*etiology
Case Report
Human
Hyperglycemic Hyperosmolar Nonketotic Coma/*complications
Male
Putaminal Hemorrhage/*etiology
Tomography, X-Ray Computed