An 85-year-old man with type 2 diabetes mellitus presented to our emergency department with sudden right limb weakness and dysarthria 90 min after onset. He was alert when examined and had a blood pressure of 163/89 mm Hg. Although right hemiplegia with facial weakness and dysarthria were noted, sensations to pinpricks were intact. MRI showed a hyperintense lesion in the posterior limb of the left internal capsule (IC), with decreased apparent diffusion coefficient values on diffusion-weighted imaging (DWI), suggesting acute ischaemic stroke (AIS) (figure 1). In the coronal plane, the lesion appeared along the pyramidal tract, suggesting a pathology other than AIS. A laboratory examination revealed a decrease in the serum glucose level (32 mg/dL), whereon 40 mL of a 50% glucose solution was infused. The patient made a complete recovery without neurological deficits; follow-up MRI 2 days later revealed complete lesion resolution (figure 2). Based on the clinical...
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