Hypoglycemic coma can be fatal if prolonged and severe. Lesions are described that involve the temporal, occipital, and insular cortex; the hippocampus; and the basal ganglia with sparing of the thalami as in our patient who is 57 year old male with significant history of hypoglycemia followed by vegetative state shows striatal hyperintensity with relative sparing of thalami. These findings can be similar to sporadic Creutzfeldt-Jacob disease, although the clinical setting should exclude the neurodegenerative disorder.
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