A hypoglycemic infant with secondary occipital brain injury defined by serial computed tomography and magnetic resonance imaging is described. An additional 22 similar cases were previously published in the English language literature. A total of 23 cases (including the present case) were reviewed. Abnormal brain imaging findings are associated with profound hypoglycemia and show involvement of the occipital lobes in 82% of affected newborns. Half of these infants had visual impairment, and their median and range of plasma glucose values, and postnatal age when hypoglycemia was first detected, were 7 mg/dL (range, 2-26 mg/dL) and 48 hours (range, 1-72 hours), respectively.
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References
1.
Spar JA, Lewine JD, Orrison Jr WW. Neonatal hypoglycemia: CT and MR findings. Am J Neuroradiol. 1994;15:1447-1448.
2.
Aslan Y, Dinc H. MR Findings of neonatal hypoglycemia. Am J Neuroradiol. 1997;18:994-995.
3.
Trail Z, Squier M, Anslow P. Brain imaging in neonatal hypoglycemia. Arch Dis Child Fetal Neonatal Ed. 1998;79:F145-F147.
4.
Barkovitch AJ, Al Ali F, Rowley HA, Bass N. Imaging patterns of neonatal hypoglycemia. Am J Neuroradiol. 1998;19:523-528.
5.
Kinnala A, Pikalainen H, Lapinleimu H, et al.Cerebral magnetic resonance imaging and ultrasonography findings after neonatal hypoglycemia. Pediatrics. 1999;103:724-729.
6.
Murakami Y, Yamashita Y, Matsuishi T, et al.Cranial MRI of neurologically impaired children suffering from neonatal hypoglycemia. Pediatr Radiol. 1999;29:23-27.
7.
Moore AM, Perlman M. Symptomatic hypoglycemia in otherwise healthy term breastfed term newborns. Pediatrics. 1999;103:837-839.
8.
Cakmakci H, Usal C, Karabay N, Kovanlikaya A. Transient neonatal hypoglycemia: cranial US and MRI findings. Eur Radiol. 2001;11:2585-2588.
9.
Caraballo RH, Saker D, Mozzi M, et al.Symptomatic occipital lobe epilepsy following neonatal hypoglycemia. Pediatr Neurol. 2004;31:24-29.
10.
Boothe RG, Greenough WT, Lund JS, Werge KA. A quantitive investigation of spine and dendritic development of neurons in visual cortex (area 17) of Macaca nemestrina monkeys. J Comp Neurol. 1979;186:473-490.
11.
Alkalay AL, Sarnat HB, Flores-Sarnat L, Moser F, Simmons CF. Neurological aspects of neonatal hypoglycemia. Isr Med Assoc J. 2005;1:188-192.
12.
Anderson JM, Milner RDG, Strich SJ. Effects of neonatal hypoglycemia on the nervous system: a pathological study. J Neurol Neurosurg Psychiatry. 1967;30:295-310.
13.
Chan R, Erbay S, Oljeski S, et al.Case report: hypoglycemia and diffusion-weighted imaging. J Comp Assist Tomogr. 2003;27:420-423.
14.
Endo H, Shimizu H, Tominaga T, Yoshimoto T. Transient hyperintensity lesions on diffusion-weighted MRI in the bilateral internal capsules due to hypoglycemic coma.(in Japanese). No to Sinkei (Brain and Nerve). 2003;55:174-175.
15.
Barkovich AJ, Westmark KD, Bedi HS, et al.Photon spectroscopy and diffusion imaging on the first day of life after perinatal asphyxia: preliminary report. Am J Neuroradiol. 2001;22:1786-1794.
16.
Robertson RL, Ben-Sira L, Barnes PD, et al.MR line-scan diffusion-weighted imaging of term neonates with perinatal brain ischemia. Am J Neuroradiol. 1999;20:1658-1670.
17.
Mazumdar A, Mukherjee P, Miller JH, et al.Diffusion-weighted imaging of acute corticospinal tract injury preceading Wallerian degeneration in the maturing human brain. Am J Neuroradiol. 2003,24:1057-1066.
