Pediatr Emerg Med J.
2020 Dec;7(2):135-139. 10.22470/pemj.2020.00122.
A case of diabetic ketoacidosis with posterior cerebral artery territory ischemic stroke mimicking uncal herniation
- Affiliations
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- 1Department of Pediatrics, Jeonbuk National University Medical School, Jeonju, Korea
- 2Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
- KMID: 2511135
- DOI: http://doi.org/10.22470/pemj.2020.00122
Abstract
- In diabetic ketoacidosis, hyperglycemia and ketosis result in cerebral vasculitis, which can cause cerebral edema and thrombosis. A previously healthy, 12-year-old girl visited the emergency department with a history of vomiting, polydipsia, polyuria, decreased mentality, and a 7 kg (12%) weight loss within 1 week. She showed laboratory features of severe diabetic ketoacidosis, stuporous mentality, respiratory failure, and unilateral fixed mydriasis with contralateral hemiparesis. However, brain magnetic resonance imaging showed multifocal ischemic stroke mainly involving the left posterior cerebral artery territory, instead of uncal herniation. This case highlights the possible occurrence of ischemic stroke in children with early-stage diabetes mellitus.
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