Reversible Diffusion Restriction is Not Always Correlatedwith Clinical Recovery in Hypoglycemic Encephalopathy

An 84-year-old female patient presented to our emergency department with unconsciousness. She was diabetic and the blood level of glucose was 34 mg/dL. Diffusion-weighted images (DWI) revealed symmetrical hyperintensity in perirolandic regions and posterior aspects of corona radiata. Hypoglycemic encephalopathy was diagnosed. Serum glucose level returned to normal ranges rapidly and abnormal signal on DWI resolved after glucose infusion, but the patient continued to be in coma. The clinical-MRI discrepancy in hypoglycemic encephalopathy is a really crucial issue for clinicians and has not been well-studied. We argued that the disappearance of abnormal signals on DWI does not always indicate a clinical recovery.