Hypoglycemia in Stroke
Low levels of glucose can result from overuse of oral hypoglycemic agents or insulin, overproduction of endogenous insulin (which may be a result of an insulinoma), or medical illnesses such as sepsis, renal failure, and hepatic failure.
Two different mechanisms have been suggested as the causes of hypoglycemia-related strokelike episodes. First, the brain uses glucose predominantly for oxidative metabolism. Different brain regions have different metabolic demands. The need for glucose is highest in the cerebral cortex and basal ganglia. The cerebellum and the subcortical white matter have less demand for this substrate. Focal deficits may be a result of asymmetric distribution of glucose transporters. Second, Gold and Marshall suggest that coagulation defects may be the cause of strokelike episodes