Tanumihardja, S. and Dikot, Y. and Hoo, Y. and Supantini, Dedeh
(2017)
Case of Ischemic Stroke with Reccurent Hypoglycemia in Pregnant Woman during the Period of Pregnancies.
Journal of Neurological Sciences, 381 (Suppl.).
p. 1109.
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Case of ischemic stroke with reccurent hypoglycemia in pregnant woman - D. Supantini.pdf
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Abstract
Background: We report a rare case, 30 years-old woman 12 weeks
of her first pregnancy admit to emergency department Immanuel
Hospital with impaired of conciousness for 3 days, laboratory finding
present hypoglycaemia, after four days there was paraparetic, CT
scan finding bilateral infarction.
Objective: Hypoglycaemia in pregnancy can caused by increased
hormones progesterone, estrogen, lactogen plasenta, GH, cortisol that
affect hormones insulin and there will be disturbances in blood sugar
levels. The symptoms of hypoglycemia are classified as neuroglycopenic
symptoms, caused by the stimulation of sympathetic nervous system
which can induce vasoconstriction, platelet aggregation and might lead
to decreased cerebral glucose availability – include confusion and focal
cerebral impairment.
Patients and Methods / Material and Methods: Laboratory findings
are normal except for Hb 9.1 mmol/l, blood glucose 37 mmol/l. There is
no external cause for hypoglycaemia, investigation for insulinoma,
nesidoblastosis, NIPHS, with USG and laboratory test of Fasting serum
insulin, serum C peptide levels, Islet cell cytoplasmic autoantibodies and
glutamic acid decarboxylase autoantibodies and ANA panel test were
normal. Laboratory investigation for prothrombotic state of pregnancy
itself or an underlying predisposition for thrombophilia were not
perform. EEG shows left frontal slowing.
Results: The hypoglycemia controlled by dextrose 5 % infusion, low
glycemic diet and antiplatelet treatment. She completed the
pregnancy and delivered full term healthy baby.
Conclusion: We report a rare case of a pregnant woman who
suffered recurrent severe reactive hypoglycemia and ischemic stroke.
We concluded that platelet activation occured after severe and
prolonged hypoglycemia with increments in platelet monocyte
aggregation lead to arterial thrombosis and caused Ischemic stroke.
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