Diabetic Striatopathy Following Radiological Improvement: An Autopsy-confirmed Case Report and Literature Review.
Yuya Ando, Masato Kadoya, Ayumu Kurihara et al.
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Case in brief
A patient with poorly controlled diabetes developed hemichorea in the setting of diabetic striatopathy and right cerebellar hemorrhagic infarction. The hemichorea emerged despite radiological improvement. At autopsy, basal ganglia tissue showed neuronal loss, reactive astrocytosis, calcification, and organizing hemorrhage with fibroblast proliferation within 82 days of the initial imaging. The pathological findings documented structural injury despite the apparent radiological normalization.
What made this case unusual
Hemichorea developed as imaging improved, while autopsy demonstrated persistent, irreversible basal ganglia injury—an important mismatch between radiological appearance and tissue pathology.
Diagnostic / clinical pearl
In diabetic striatopathy, radiological improvement does not necessarily indicate resolution of basal ganglia injury; persistent or new movement symptoms may coexist with structural damage.
Why it matters
The autopsy findings support a spectrum of diabetic striatopathy extending from functional disturbance to structural injury.