Exofocal Anterograde Transsynaptic Neuronal Death in the Globus Pallidus: Two Case Reports
A 70-year-old woman visited the emergency room because of decreased mentality. She had been diagnosed with diabetes mellitus, and medication had been initiated 1 month prior to the visit. Two days before admission she was unable to recognize her family, and 1 day before admission she experienced drowsiness. On admission she exhibited a stuporous mental state. Her blood glucose level and oxygen tension were 169 mg/dL and 69.1 mm Hg, respectively. Cerebrospinal fluid findings were normal. Brain magnetic resonance imaging (MRI) was performed on the first day of admission; a diffusion-weighted image disclosed high-intensity signals in the caudate nucleus, putamen, and temporooccipital cortex on both sides. Follow-up (diffusion-weighted) MRI performed 10 days after admission revealed a decreased signal intensity in the caudate head and putamen on both sides, but new high-intensity signals had developed in the SN and GP on both sides ().