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Microhemorrhages in MELAS Lesions: A Case Report

Evelien Martens1, Jelle Demeestere1, Benjamin Verhaaren1

  • 1UZLeuven, BE.

Journal of the Belgian Society of Radiology
|October 17, 2022
PubMed
Abstract

Insights

Microhemorrhages, not previously seen in MELAS, were detected on MRI in a patient with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes. This finding may indicate mitochondrial microangiopathy.

Area of Science:

  • Neurology
  • Radiology
  • Genetics

Background:

  • Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) is a rare genetic disorder.
  • Typical MRI findings in MELAS include stroke-like lesions, often in the cortex and subcortical white matter.

Observation:

  • A patient with MELAS experienced multiple acute stroke-like episodes.
  • MRI revealed characteristic MELAS lesions with vasogenic edema but no diffusion restriction.
  • Notably, microhemorrhages were observed within these MELAS lesions on MRI.

Findings:

  • Microhemorrhages are an atypical imaging finding in MELAS.
  • The presence of microhemorrhages in MELAS lesions has not been previously reported.
  • These findings suggest that microhemorrhages may be associated with MELAS.

Implications:

  • Microhemorrhages in MELAS lesions could signify underlying mitochondrial microangiopathy.
  • This observation expands the spectrum of MRI findings in MELAS.
  • Further research is warranted to understand the mechanism and clinical significance of microhemorrhages in MELAS.
Keywords:
MELASMRImicrobleedsmicrohemorrhagesstroke-like episodes

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