Concepts and Controversies in Nonketotic Hyperglycemia-Induced Hemichorea: Further Evidence from Susceptibility-Weighted MR Imaging

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dc.contributorCherian, Ajith
dc.contributorThomas, Bejoy
dc.contributorBaheti, Neeraj N.
dc.contributorChemmanam, Thomas
dc.contributorKesavadas, Chandrasekharan
dc.date.accessioned2012-12-04T11:43:43Z
dc.date.available2012-12-04T11:43:43Z
dc.date.issued2009
dc.description.abstractHyperglycemia-induced hemichorea can show T1 hyperintensity of the contralateral striatum on MRI. This is thought to be due to petechial hemorrhages or gemistocytic astrocyte accumulation. This study explores the utility of susceptibility-weighted imaging (SWI) and diffusion-weighted imaging (DWI) in identifying the nature of these lesions. Three patients underwent MR imaging of the brain with SE T1, F SE T2. DWI, and SWI. T1 images showed hyperintensity predominantly involving the contralateral striatum, where mild (two cases) to moderate (one case) restricted diffusion (low apparent diffusion coefficient [ADC]) was detected on DWI. SWI demonstrated bilateral symmetrical hypointensities in the first two cases, suggesting age associated mineralization. In addition, increased susceptibility change (hypointensity) was also noted in the right putamen in the first and the third cases, suggesting paramagnetic mineral deposition. T1 hyperintensity may be from the protein hydration layer inside the cytoplasm of swollen gemistocytes appearing after an acute cerebral injury. These astrocytes also express metallothionein with zinc, which is thought to be the cause of asymmetric hypointensity of the posterior putamen on SWI. ADC values were thought to be useful for prognostication: however, they should be interpreted cautiously in the presence of susceptibility changes.
dc.identifier.citationJOURNAL OF MAGNETIC RESONANCE IMAGING. 29; 3; 699-703en_US
dc.identifier.urihttp://dx.doi.org/10.1002/jmri.21672
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/pubmed/19243044
dc.identifier.urihttps://dspace.sctimst.ac.in/handle/123456789/288
dc.publisherJOURNAL OF MAGNETIC RESONANCE IMAGING
dc.subjectRadiology
dc.titleConcepts and Controversies in Nonketotic Hyperglycemia-Induced Hemichorea: Further Evidence from Susceptibility-Weighted MR Imaging
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