Typical and non-typical magnetic resonance imaging findings of neonatal hypoglycemic encephalopathy

Abstract

To analyze the typical and non-typical magnetic resonance imaging (MRI) findings of neonatal hypoglycemia encephalopathy (NHE). The clinical data and MRI findings of 20 cases with NHE were retrospectively evaluated. Among them, blood glucose values were ≤ 1.4 mmol/L (n = 18) and 2.1 mmol/L (n = 2). And 13 cases had recurrent hypoglycemia. The major clinical symptoms included convulsion, poor response, cyanosis and apnea. The typical MRI findings of abnormal signal in occipital or parietal cortex were found in 9 cases. And the involvement sites were corpus callosum (n = 4) and posterior limb of internal capsule (n = 1). Another 11 cases revealed non-typical MRI findings of damaged brain regions, involving splenium of corpus callosum (n = 8), white matte along lateral ventricle (n = 6), extensive cortical or subcortical white matter (n = 5), internal capsule (n = 3), centrum semiovale (n = 2), globus pallidus (n = 1), local cortex (frontal lobe) (n = 1), pons (n = 1), unilateral hippocampus (n = 1) and bilateral thalamus and midbrain, brain stem and medulla oblongata (n = 1). The typical MRI findings of NHE show abnormal signal in occipital or parietal cortex. And non-typical manifestations involving multiple brain areas may be observed in cases of severe NHE.