Abstract
In a 13-month-old boy with recurrent motor deterioration provoked by fever MRI and proton MRS detected a leukoencephalopathy with reduced cerebral metabolites and elevated lactate. At follow-up 6 and 16 months later these abnormalities improved gradually. Serial diffusion tensor imaging revealed a stroke-like pattern with an initial strong reduction of the apparent diffusion coefficient followed by elevated values 6 months later. The relative diffusion anisotropy remained reduced. Muscle biopsy confirmed a mitochondrial encephalomyopathy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Frahm J, Hanefeld F (1996) Localized proton magnetic resonance spectroscopy of cerebral metabolites. Neuropediatrics 27:64–69
Pouwels PJ, Brockmann K, Kruse B et al. (1999) Regional age dependence of human brain metabolites from infancy to adulthood as detected by quantitative localized proton MRS. Pediatr Res 46:474–485
Nolte U, Finsterbusch J, Frahm J (2000) Rapid isotropic diffusion mapping without susceptibility artifacts. Whole brain studies using diffusion-weighted single-shot STEAM MR imaging. Magn Reson Med 44:731–736
Pierpaoli C, Basser PJ (1996) Toward a quantitative assessment of diffusion anisotropy. Magn Reson Med 36:893–906
Engelbrecht V, Scherer A, Rassek M et al. (2002) Diffusion-weighted MR imaging in the brain of children: findings in normal brain and in the brain with white matter diseases. Radiology 222:410–418
Sener RN (2002) Metachromatic leukodystrophy: diffusion MR imaging findings. Am J Neuroradiol 23:1424–1426
Phillips MD, McGraw P, Lowe MJ et al. (2001) Diffusion-weighted imaging of white matter abnormalities in patients with phenylketonuria. Am J Neuroradiol 22:1583–1586
Majoie CB, Akkerman EM, Blank C et al. (2002) Mitochondrial encephalomyopathy: comparison of conventional MR imaging with diffusion-weighted and diffusion tensor imaging: case report. Am J Neuroradiol 23:813–816
Lansberg MG, Thijs VN, O’Brien MW et al. (2001) Evolution of apparent diffusion coefficient, diffusion-weighted, and T2-weighted signal intensity of acute stroke. Am J Neuroradiol 22:637–644
Wardlaw JM, Marshall I, Wild J et al. (1998) Studies of acute ischemic stroke with proton magnetic resonance spectroscopy: relation between time from onset, neurological deficit, metabolite abnormalities in the infarct, blood flow, and clinical outcome. Stroke 29:1618–1624
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brockmann, K., Finsterbusch, J., Schara, U. et al. Stroke-like pattern in DTI and MRS of childhood mitochondrial leukoencephalopathy. Neuroradiology 46, 267–271 (2004). https://doi.org/10.1007/s00234-004-1181-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00234-004-1181-7