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CT, MRI, and autopsy findings in brain of a patient with MELAS
Abstract:
Brain autopsy findings in a 14-year-old patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes were compared with those of computed tomography (CT) and magnetic resonance imaging (MRI). Pathologic examinations revealed extensive laminar necrosis bordered by gliotic tissues throughout the cerebral cortices. Moderate losses of myelin and fibrous gliosis were also observed in the subcortical and deep white matter. These lesions were demonstrated as low-density areas on CT and as high-signal areas on T2-weighted MRI. MRI revealed the lesions more distinctively and precisely than CT. Neither CT nor MRI could reveal abnormalities in the basal ganglia, including vascular proliferation and calcium deposits in the blood vessels.
Insights
Brain autopsy in a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes showed extensive cortical necrosis. Imaging, particularly MRI, effectively identified these lesions, though not basal ganglia abnormalities.
Area of Science:
- Neurology
- Neuroimaging
- Pathology
Background:
- Mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) is a rare genetic disorder.
- Accurate diagnosis and understanding of MELAS-related brain pathology are crucial for patient management.
Observation:
- This study compared brain autopsy findings with computed tomography (CT) and magnetic resonance imaging (MRI) in a 14-year-old MELAS patient.
- Pathologic examination revealed extensive laminar necrosis and gliosis in cerebral cortices and white matter.
Findings:
- CT showed lesions as low-density areas, while T2-weighted MRI revealed them as high-signal areas.
- MRI provided more distinct and precise visualization of the lesions compared to CT.
- Neither imaging modality detected abnormalities in the basal ganglia.
Implications:
- MRI is a valuable tool for detecting MELAS-related cerebral lesions.
- Autopsy-confirmed findings enhance the understanding of MELAS neuropathology.
- Further research may explore advanced imaging techniques for detecting subtle basal ganglia changes in MELAS.