Autopsy of a patient with diabetic striatopathy revealed irreversible structural damage, including neuronal loss and calcification, despite prior radiological improvement on CT.
Case Report (n=1)
No
Diabetic striatopathy can progress to irreversible structural damage, including calcification and organizing hemorrhage, even after apparent radiological improvement and glycemic stabilization.
Diabetic striatopathy (DS) is a rare neurological complication in poorly controlled diabetes mellitus. The pathogenesis of DS is thought to involve microvascular injury; however, autopsy-based histological documentation remains scarce. We report an autopsy-confirmed case of DS complicated by right cerebellar hemorrhagic infarction, in which hemichorea developed despite radiological improvement. A histological examination showed neuronal loss, reactive astrocytosis, calcification, and organizing hemorrhage with fibroblast proliferation in the basal ganglia within 82 days after the initial imaging. These findings highlight the paradox between radiological normalization and irreversible pathological injury, supporting DS as a spectrum that extends from functional disturbance to structural damage.
Ando et al. (2026) conducted a case report in Diabetic striatopathy (n=1). Glycemic control (insulin, metformin, sitagliptin) was evaluated. Autopsy of a patient with diabetic striatopathy revealed irreversible structural damage, including neuronal loss and calcification, despite prior radiological improvement on CT.