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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1840-1844, August 2005
© 2005 American Society of Neuroradiology

Case Report
BRAIN

MR Diffusion Tensor Imaging, Fiber Tracking, and Single-Voxel Spectroscopy Findings in an Unusual MELAS Case

Denis Ducreux^a, Ghaidaa Nasser^a, Catherine Lacroix^b, David Adams^b and Pierre Lasjaunias^a

^a Department of Neuroradiology and the Intensive Care Unit, CHU de Bicêtre, Paris XI University, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
^b Department of Neurology and the Intensive Care Unit, CHU de Bicêtre, Paris XI University, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France

Address correspondence to Denis Ducreux, Department of Neuroradiology, CHU de Bicêtre, Paris XI University, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France (e-mail: denis.ducreux{at}bct.ap-hop-paris.fr)

Summary: A 23-year-old man was admitted to the intensive care unit for respiratory failure, global lower and upper limb palsy, and higher cognitive function deterioration. Imaging, performed with a combination of the MR diffusion tensor imaging, fiber tracking, and MR spectroscopy, suggested the diagnosis of an acute severe unusual mitochondrial encephalopathy, lactic acidosis, and strokelike event, which was confirmed by muscle biopsy, but fiber tracking showed unexpected unaltered white matter tracts.