Romario M. Ramos
Medical Mission Group Hospital and Health Services Cooperative of Oriental Mindoro (MMGHMCOM), Philippines
Title: Radiologic Features of Diabetic Striatopathy in a Patient Presenting with Seizures and Stroke-Like Symptoms
Biography
Biography: Romario M. Ramos
Abstract
A diagnositic and a therapeutic dilemma arise when radiologic findings point to several medical conditions each with a different approach to management. We present a 61-year-old male admitted due to decreased sensorium, hyperglycemia, seizures and right-sided hemiparesis. A computed axial tomography (CT) scan of the brain showed a hyperdense focus in the left caudate and lentiform nucleus suggestive of diabetic striatopathy (DS). The patient was mananged as a case of acute ischemic stroke and was given an antithrombotic drug among other medications due to the radiologic features that point more toward DS, in spite the absence of hemiballismus-hemichorea typical in this disorder, rather than as a hemorrhagic stroke. The patient’s symptoms improved including his blood sugar levels. A repeat cranial CT scan done after 3 days showed an interval decrease in the density of the lesion. DS is considered uncommon and the absence of hyperkinetic movements typical of DS as seen in this patient makes it challenging to the physician in terms of treatment especially in the acute setting. Recognizing the possibility of a purely radiologic DS diagnosis as well as the association of DS with other comorbidities such as stroke and seizures are future directions we can take to fully understand this rare condition.