Clinical and radiographic intersection of cerebral amyloid angiopathy with euglycemic diabetic ketoacidosis in the development of transient focal neurologic deficits: case report

Reversible T2 FLAIR hypointensity has been described in hyperglycemia-associated syndromes. In this case, T2 FLAIR hypointensity likely represented metabolic dysregulation that triggered cortical dysfunction within brain regions at risk due to heavy CAA-related microbleed burden. We speculate that a common pathway for the development of the patient's transient deficits resulted from cortical spreading depolarization (CSD), which has been associated with both CAA and hyperglycemia.