Perfusion status of the stroke-like lesion at the hyperacute stage in MELAS

Hsu Ling Yeh, Yen Kung Chen, Wei Hung Chen, Han Cheng Wang, Hou Chang Chiu, Li-Ming Lien, Yau Huei Wei

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Hypoperfusion on single-photon emission computed tomography (SPECT) of the stroke-like lesion (SLL) at the hyperacute stage of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) is considered to be a supportive evidence of the mitochondrial angiopathy theory. Our objectives were to examine whether other neuroimages, especially transcranial color-coded sonography (TCCS), done at the hyperacute stage of stroke-like episode (SLE) is consistent with hypoperfusion of the SLL. We reviewed the magnetic resonance imaging (MRI), SPECT, cerebral angiography, and TCCS of a patient with MELAS syndrome, all of which were performed at the hyperacute stage of one SLE. MRI on the 1st day post SLE showed right temporoparietal lesion with vasogenic edema. SPECT on the 2nd day showed focal decreased uptake of technetium-99m hexamethylpropyleneamine oxime (99mTc-HMPAO) in the same region, but cerebral angiography and TCCS on the 3rd day showed increased regional cerebral blood flow (rCBF) and distal arteriole dilation in the same region. TCCS can delineate increased rCBF of the SLL at the hyperacute stage of SLE. We propose that the discrepancy between the decreased 99mTc-HMPAO uptake and increased rCBF might be caused by mitochondrial dysfunction. The phenomenon of "hypoperfusion" on SPECT might be caused by cell dysfunction but not decreased rCBF. We suggest that SPECT can be complemented by angiography and TCCS in future studies to delineate the perfusion status of SLLs.

Original languageEnglish
Pages (from-to)158-164
Number of pages7
JournalBrain and Development
Volume35
Issue number2
DOIs
Publication statusPublished - Feb 2013

Fingerprint

Lactic Acidosis
Perfusion
Stroke
Cerebrovascular Circulation
Single-Photon Emission-Computed Tomography
Regional Blood Flow
Ultrasonography
Color
Technetium Tc 99m Exametazime
Cerebral Angiography
Magnetic Resonance Imaging
Mitochondrial encephalopathy
Technetium
Arterioles
Dilatation
Edema
Angiography

Keywords

  • Cerebral blood flow
  • MELAS
  • SPECT
  • TCCS

ASJC Scopus subject areas

  • Clinical Neurology
  • Developmental Neuroscience
  • Pediatrics, Perinatology, and Child Health

Cite this

Yeh, H. L., Chen, Y. K., Chen, W. H., Wang, H. C., Chiu, H. C., Lien, L-M., & Wei, Y. H. (2013). Perfusion status of the stroke-like lesion at the hyperacute stage in MELAS. Brain and Development, 35(2), 158-164. https://doi.org/10.1016/j.braindev.2012.03.017

Perfusion status of the stroke-like lesion at the hyperacute stage in MELAS. / Yeh, Hsu Ling; Chen, Yen Kung; Chen, Wei Hung; Wang, Han Cheng; Chiu, Hou Chang; Lien, Li-Ming; Wei, Yau Huei.

In: Brain and Development, Vol. 35, No. 2, 02.2013, p. 158-164.

Research output: Contribution to journalArticle

Yeh, Hsu Ling ; Chen, Yen Kung ; Chen, Wei Hung ; Wang, Han Cheng ; Chiu, Hou Chang ; Lien, Li-Ming ; Wei, Yau Huei. / Perfusion status of the stroke-like lesion at the hyperacute stage in MELAS. In: Brain and Development. 2013 ; Vol. 35, No. 2. pp. 158-164.
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