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Korean J Crit Care Med > Volume 27(4); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(4): 209-217. doi: https://doi.org/10.4266/kjccm.2012.27.4.209
저혈당성 뇌병증의 예후 인자에 대한 고찰
서익권ㆍ최우익ㆍ진상찬ㆍ장혁원*
계명대학교 의과대학 동산의료원 응급의학과, *영상의학과
Consideration of Prognostic Factors in Hypoglycemic Encephalopathy
Ik Kwon Seo, Woo Ik Choi, Sang Chan Jin, Hyuk Won Chang
1Department of Emergency Medicine, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Korea. emtaegu@dsmc.or.kr
2Department of Radiology, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Korea.
ABSTRACT
BACKGROUND: Recently, there are many reports about the association of Diffusion Weighted Imaging (DWI) and the prognosis of hypoglycemic encephalopathy (HE), but those relationships have not yet been completely determined. As such, we researched for prognosis, according to a variety of clinical data, and the lesion's distribution on DWI. METHODS: We retrospectively reviewed 19 patients who were diagnosed as HE. In addition, those prognoses were analyzed by a variety of clinical data and characteristics of lesion's distribution, which were evaluated on DWI and Apparent Diffusion Coefficient (ADC) maps. Three months later, those prognoses were determined by each Modified Rankin Scale. Further, the time-dependent average Glasgow Coma Scale (GCS), among the groups according to the characteristics of lesion's distributions in the initial DWI, was estimated. RESULTS: In this study, the difference of prognosis was not shown, according to all the clinical data, such as the severity or duration of the hypoglycemic state, but the group that did not have any pathologic lesion on the initial DWI demonstrated a better prognosis, in comparison with the groups-that exhibited any positive lesion on the initial DWI (p = 0.006). The group that had a focal pathologic lesion on the initial DWI showed a better prognosis than the diffuse lesion's group (p = 0.045). The groups with no lesion or focal lesion showed a faster recovery of GCS than the other groups with a positive lesion or diffuse lesion within the initial 1 week. CONCLUSIONS: We can identify that the characteristics of the lesion's distribution of DWI can be more helpful to predict of prognosis in HE than a variety of clinical data, such as the severity or duration of the hypoglycemic state.
Key Words: diffusion weighted imaging; hypoglycemia; prognosis
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