PMC10076595_01
Cranial MRI on admission.
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F1
The cranial MRI plain scan showed no abnormalities (Figure 1); the electroencephalogram suggested diffuse slow wave activity and paroxysmal epileptiform wave issuance during clinical symptom onset.
The changing trend of blood glucose concentration on the 1st day of admission.
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F2
On the 1st day of admission, the child's hypoglycemia was difficult to correct and we gave several pushes of 50% glucose solution, along with a continuous infusion of 10% glucose solution and adjusted the pumping rate according to the child's blood glucose level (Figure 2).
PMC10076595_02
Cranial MRI on 4th day.
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F3
Bilateral ventricles were slightly narrowed, the suprasellar cisterna, prepontine cisterna and fourth ventricle were significantly narrowed and the position of the lower margin of the cerebellar hemisphere was moved down ~6.3 mm below the line of the foramen magnum, thus suggesting cerebral edema, cerebellar tonsillar hernia, and bilateral temporal sulcus hernia (Figure 3).
Cranial MRI on 10th day.
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F4
The cranial MRI was repeated at 10 days after admission, the bilateral cerebral hemispheres were still swollen, the images were essentially the same as the previous analysis, suggesting increased cerebral edema, cerebellar tonsillar hernia and bilateral temporal sulcus hernia (hernias were worse than the anterior one; Figure 4).