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AJNR - American Journal of Neuroradiology

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Unilateral Putaminal CT, MR, and Diffusion Abnormalities Secondary to Nonketotic Hyperglycemia in the Setting of Acute Neurologic Symptoms Mimicking Stroke

Max Wintermark^a,b, Nancy J. Fischbein^a, Pratik Mukherjee^a, Esther L. Yuh^a and William P. Dillon^a

^a Department of Radiology, Neuroradiology Section, University of California, San Francisco
^b the Department of Diagnostic and Interventional Radiology, University Hospital Center, Lausanne, Switzerland

View larger version (91K): [in a new window]   FIG 1. MR images of the brain obtained during the patient’s first admission. The left putamen is hyperintense on T1-weighted images (A) and hypointense on T2-weighted (B) and FLAIR images (C). The left putamen (circles [D and E]) appears hyperintense on the exponential DW images (b = 1000-s/mm2 images divided by b = 0-s/mm2 images [5]) (D) and hypointense on the ADC maps (E). A subtle focus of reduced ADC is also present in the posterior aspect of the right putamen (arrows). Lipoma of the corpus callosum is incidentally noted (C, arrowhead).

View larger version (91K): [in a new window]   FIG 2. Noncontrast cranial CT scan obtained during the patient’s second admission shows faint hyperattenuation of the entire left putamen, without evidence of mass effect, edema, or volume loss and with no sign of brain ischemia.