Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS)

Case contributed by Dr Chris O'Donnell

Presentation

Two weeks of headache, blurred vision, reduced concentration.

Patient Data

Age: 45
Gender: Male

Multiple bilateral areas of cortical and subcortical hypodensities in different vascular territories as well as bilateral basal ganglia calcification.

Widespread areas of apparent ischaemia of varying ages in non-vascular territories, some with reduced ADC and some without. 

Considerable enhancement in left anterior temporal lobe consistent with laminar necrosis. 

Case Discussion

Widespread areas of apparent ischaemia of varying ages in non-vascular territories, some with reduced ADC and some without - there is an ongoing debate about whether the stroke-like incidents in MELAS are ischaemic or metabolic or both.          

This patient has a family history of mitochondrial disease.        

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Case information

rID: 16324
Case created: 11th Jan 2012
Last edited: 24th Mar 2017
Inclusion in quiz mode: Included

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