Cerebral blood flow in mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes.
OBJECTIVE
The precise mechanism of neurological symptoms with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) is still controversial. We investigated the correlation between strokelike episodes and cerebral blood flow in two patients with MELAS and discuss the pathogenesis of strokelike episodes with MELAS.


METHODS
Cerebral dynamic computed tomography and cerebral angiography were used to measure cerebral circulation in the first case, that of a 20-year-old woman with MELAS. The second subject was a 13-year-old female who was studied with xenon-enhanced computed tomography. The cerebral blood flow studies were performed 3-72 hours after the onset of strokelike episodes. Serial cerebral angiography, dynamic computed tomography, and xenon-enhanced computed tomography showed vasodilation localized in the affected cerebral cortexes during strokelike episodes, without any reduction in regional cerebral blood flow.


CONCLUSIONS
Our study suggests that the strokelike episodes associated with MELAS are different in origin from ischemic stroke.
Ooiwa
Y
Y
Department of Neurological Surgery, Wakayama Medical College, Japan.
Uematsu
Y
Y
Terada
T
T
Nakai
K
K
Itakura
T
T
Komai
N
N
Moriwaki
H
H
D000293:Adolescent; D000328:Adult; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D017241:MELAS Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*