What does this research mean for the field?

Diabetic striatopathy can coexist with peri-ictal cortical lesions in nonketotic hyperglycemia, resulting in a misleading stroke-like presentation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe an atypical presentation of nonketotic hyperglycemia manifesting with concurrent diabetic striatopathy and peri-ictal cortical diffusion restriction that mimicked acute ischemic stroke.

August 23, 2026Radiology Case ReportsOpen Access

Diabetic striatopathy and concurrent peri-ictal cortical diffusion restriction in nonketotic hyperglycemia: A rare stroke mimic

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Authors

AKAnwar Kalali AHAli Haidar OHOmar Handi

Discussion

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Overview

Case report demonstrates diabetic striatopathy and peri-ictal cortical lesions mimicking acute stroke in nonketotic hyperglycemia, highlighting key diagnostic challenges in metabolic stroke mimics.

Key Points

To describe an atypical presentation of nonketotic hyperglycemia manifesting with concurrent diabetic striatopathy and peri-ictal cortical diffusion restriction that mimicked acute ischemic stroke.
Evaluated a 77-year-old female with type 2 diabetes presenting with afebrile status epilepticus, progressive left hemiplegia, and severe hyperglycemia (480 mg/dL) without ketoacidosis (N=1).
Conducted multimodal diagnostic imaging and testing, including electroencephalography, noncontrast head CT, brain MRI (T1, T2/FLAIR, DWI, ASL), and MR angiography.
Brain MRI revealed right striatal T1 hyperintensity and T2/FLAIR hypointensity without diffusion restriction, alongside a right frontal FLAIR-hyperintense, diffusion-restricted cortical lesion.
Electroencephalography demonstrated right parietotemporal focal ictal onset, while MR angiography confirmed patency of the right anterior circulation without focal hyperperfusion.
Treatment with antiseizure medications and intensive glycemic control led to the complete resolution of status epilepticus and progressive neurological recovery.

Cite This Study

Kalali et al. (2026) studied this question.

synapsesocial.com/papers/6a8aad417677a3411444575b https://doi.org/10.1016/j.radcr.2026.07.054

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August 23, 2026Radiology Case ReportsOpen Access

Diabetic striatopathy and concurrent peri-ictal cortical diffusion restriction in nonketotic hyperglycemia: A rare stroke mimic

View Full Paper

Ask AI

Bookmark

Authors

AKAnwar Kalali AHAli Haidar OHOmar Handi

Discussion

Member takes

Overview

Case report demonstrates diabetic striatopathy and peri-ictal cortical lesions mimicking acute stroke in nonketotic hyperglycemia, highlighting key diagnostic challenges in metabolic stroke mimics.

Key Points

To describe an atypical presentation of nonketotic hyperglycemia manifesting with concurrent diabetic striatopathy and peri-ictal cortical diffusion restriction that mimicked acute ischemic stroke.
Evaluated a 77-year-old female with type 2 diabetes presenting with afebrile status epilepticus, progressive left hemiplegia, and severe hyperglycemia (480 mg/dL) without ketoacidosis (N=1).
Conducted multimodal diagnostic imaging and testing, including electroencephalography, noncontrast head CT, brain MRI (T1, T2/FLAIR, DWI, ASL), and MR angiography.
Brain MRI revealed right striatal T1 hyperintensity and T2/FLAIR hypointensity without diffusion restriction, alongside a right frontal FLAIR-hyperintense, diffusion-restricted cortical lesion.
Electroencephalography demonstrated right parietotemporal focal ictal onset, while MR angiography confirmed patency of the right anterior circulation without focal hyperperfusion.
Treatment with antiseizure medications and intensive glycemic control led to the complete resolution of status epilepticus and progressive neurological recovery.

Cite This Study

Kalali et al. (2026) studied this question.

synapsesocial.com/papers/6a8aad417677a3411444575b https://doi.org/10.1016/j.radcr.2026.07.054

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