Microhemorrhages in MELAS Lesions: A Case Report.

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.