ESPE Abstracts (2014) 82 P-D-3-3-754

Ketoacidosis-Associated Stroke: Cerebral Infarction

Zerrin Orbak, Hakan Doneray, Seda Yesilcibik, Mecit Kantarci, Huseyin Tan, Nuran Kucuk & Celalettin Kosan


Medical Faculty, Ataturk University, Erzurum, Turkey


Background: Type 1 diabetes mellitus (T1DM) is a common autoimmune condition in childhood and may be complicated by episodes of diabetic ketoacidosis (DKA). DKA is a state of severe insulin deficiency, resulting in hyperglycemia, ketonemia, acidemia, and systemic inflammation. This is predominantly attributable to intracerebral complications. We report a girl with a newly diagnosed T1DM who presented with DKA and cerebral infarction.

Case: A 13-year-old previously healthy girl with DKA became unconsciousness and anisocoria. Babinski reflex was positive on the right side of the body. She was treated for DKA and cerebral edema. Magnetic resonance imaging provided evidence for lacunar subcortical infarcts and deep white matter changes.

Conclusion: Children and adolescents who present with DKA should be monitored for neurologic deficits and must be investigated for both stroke and cerebral edema in the event of neurologic deterioration.

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