Teaching NeuroImage: hippocampal involvement in a patient with hypoglycemic coma.

A 55-year-old diabetic man presented with coma for 2 days. Neurologic examination did not reveal any lateralizing signs and moderate hypoglycemia (43 mg/dL) was noted. Under the assumption of hypoglycemic coma, 50% dextrose solution of 50 mL was given IV, which normalized his mental status. Brain MRI showed high signal intensity lesions in the bilateral hippocampi from CA1 to CA3 areas (figure), which were vulnerable areas on experimental hypoglycemia.1 Neuropsychological examination showed marked anterograde amnesia, which persisted over 2 months.