Differential diagnosis of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) and ischemic stroke using 3D pseudocontinuous arterial spin labeling

Abstract

3 J. Magn. Reson. Imaging 2017;45:199-206.

Increased cerebral blood flow as a predictor of episodes in MELAS using multimodal MRI

“…It predominantly involves gray matter and is not confined to vascular territories . According to previous research, hyperperfusion in acute encephalomyopathy represents an imaging landmark distinct from ischemia . Several important factors thought to contribute to hyperperfusion are vasodilation, breakdown of blood–brain barrier, and increased vascular permeability.…”

“…1 According to previous research, hyperperfusion in acute encephalomyopathy represents an imaging landmark distinct from ischemia. [2][3][4] Several important factors thought to contribute to hyperperfusion are vasodilation, breakdown of blood-brain barrier, and increased vascular permeability. However, a preclinical imaging pattern has yet to be elucidated.…”

Mutación m.3271T>C del gen MTTL1 en encefalopatía mitocondrial, acidosis láctica y episodios stroke like (MELAS) en edad pediátrica. A propósito de un caso

“…La hiperperfusión podría ser el resultado directo de la anormalidad en los mecanismos autorregulatorios vasculares en la angiopatía mitocondrial especialmente en las regiones corticales a causa de los abundantes vasos en estas zonas. [8][9][10][11] Otras secuencias que se sugieren en el trabajo de Xie son la extracción de fracción de oxígeno, así como secuencia BOLD (blood-oxygen-level-dependent) como un complemento para el diagnóstico. 8 Lo característico del caso es la presentación clí-nica tan severa en el segundo internamiento de nuestra paciente con manifestaciones sistémicas determinadas por acidemia e hiperlactatemia confirmada lo que a su vez comprometió seriamente el estado hemodinámico y ventilatorio de la paciente.…”

Hyperperfusion in DWI Abnormality in a Patient with Acute Symptomatic Hypoglycemic Encephalopathy

“…Although this is a single-case experience, localized hyperperfusion in ASHE may mean preservation of compensatory function of CBF control, and it may be associated with good prognosis. The increased perfusion in the DWI abnormality has been described also in the acute phase of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) (7,8). ASHE or MELAS can manifest focal neurological deficit like as acute ischemic stroke, and hyperperfusion in the area of DWI abnormality.…”