{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:32:35Z","timestamp":1793151155987,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2006,4,10]],"date-time":"2006-04-10T00:00:00Z","timestamp":1144627200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropathology"],"published-print":{"date-parts":[[2006,4]]},"abstract":"<jats:p>Here we report an autopsy case of hypoglycemic encephalopathy with prolonged coma. Laboratory data obtained when the patient lapsed into a coma showed that she had a low level of serum glucose (27\u2003mg\/dL). Although the level of glucose returned to within the normal range rapidly after glucose infusion, the patient remained in a coma for 22\u2003months. It was presumed that the state of hypoglycemia persisted for about 4\u2003h. There was no evidence of hypotension or hypoxia. Magnetic resonance imaging was performed 3\u2003h after glucose administration; diffusion\u2010weighted images revealed hyperintensity in the cerebral white matter and in the boundary zone between the middle and posterior cerebral arteries. Post\u2010mortem examination revealed superficial laminar necrosis throughout the cerebral cortex. Neuronal necrosis was also found in the hippocampus and dentate gyrus, although the CA3 region appeared normal. In addition to these lesions, which are consistent with hypoglycemia\u2010induced brain damage, the cerebral white matter exhibited severe loss of myelin and axons with reactive astrocytosis and macrophage infiltration. Old infarcts were also present in the bilateral occipital lobes. Since the cerebral blood flow is reported to be decreased during severe hypoglycemia, the present findings suggest that white matter lesions and boundary\u2010zone infarctions may develop primarily in uncomplicated hypoglycemia.<\/jats:p>","DOI":"10.1111\/j.1440-1789.2006.00656.x","type":"journal-article","created":{"date-parts":[[2006,4,10]],"date-time":"2006-04-10T10:23:07Z","timestamp":1144664587000},"page":"147-152","source":"Crossref","is-referenced-by-count":41,"title":["Hypoglycemic encephalopathy with extensive lesions in the cerebral white matter"],"prefix":"10.1111","volume":"26","author":[{"given":"Fumiaki","family":"Mori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Nishie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Houzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Wakabayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,4,10]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.17.4.699"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410240602"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1980.tb03047.x"},{"key":"e_1_2_6_5_2","first-page":"63","article-title":"Neuropathologic findings in three cases of profound hypoglycemia","volume":"8","author":"Auer RN","year":"1989","journal-title":"Clin Neuropathol"},{"key":"e_1_2_6_6_2","first-page":"236","article-title":"Neuronal vulnerability to hypoxia and hypoglycemia (in Japanese with English abstract)","volume":"36","author":"Takeda S","year":"1992","journal-title":"Shinkei Kenkyu No Shinpo [Adv Neurol Sci]"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2990.2000.00273.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688108"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688120"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688121"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00688122"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000130181.05016.68"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1017\/S031716710004052X"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.3.584"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.5.933-a"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-200305000-00020"},{"key":"e_1_2_6_17_2","first-page":"233","volume-title":"Greenfield's Neuropathology","author":"Auer RN","year":"2002"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0026-0495(92)90310-7"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02743269"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(98)00031-X"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.1980.tb06601.x"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1965.tb06782.x"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1978.tb06236.x"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.1985.tb08723.x"}],"container-title":["Neuropathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1440-1789.2006.00656.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1440-1789.2006.00656.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T07:53:29Z","timestamp":1696924409000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1440-1789.2006.00656.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,4]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2006,4]]}},"alternative-id":["10.1111\/j.1440-1789.2006.00656.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1440-1789.2006.00656.x","archive":["Portico"],"relation":{},"ISSN":["0919-6544","1440-1789"],"issn-type":[{"value":"0919-6544","type":"print"},{"value":"1440-1789","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,4]]}}}