Document Detail


Diaschisis in cerebral mitochondrial disorder.
MedLine Citation:
PMID:  18645370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This report highlights the presence of extensive cerebral dysfunction in a patient with cerebral mitochondrial disorder. MATERIALS AND METHODS: The patient is a 10-year-old girl with a history of hemiparesis, encephalopathy, developmental delay, and seizures. She underwent 1H magnetic resonance spectroscopic imaging, magnetic resonance imaging (MRI), and high-resolution regional cerebral blood flow (rCBF) obtained through Tc-99m ethylcysteinate dimer brain SPECT. After 1 year, a follow-up rCBF SPECT scan was obtained. RESULTS: Magnetic resonance spectroscopy showed a relative decrease in N-acetylaspartate in the cerebellar hemispheres and relatively increased choline, indicating increased cerebellar lipid accumulation. MRI findings showed a lack of myelination in the posterior limb of the internal capsule, whereas rCBF showed reduction in the associated gray matter. On parametric statistical analysis of rCBF using 3D-SSP, the reduction in blood flow in both initial and follow-up scans was found to be greater than 3 standard deviations below the mean in the occipital lobes. Cerebral dysfunction could be attributed to an intrinsic abnormality of the gray matter or diaschisis from dysfunctional white matter. CONCLUSIONS: Quantitative assessment of imaging in patients with suspected mitochondrial disorder with only subtle changes on MRI may be better characterized using rCBF and parametric statistical mapping to localize and assess the extent of damage in the brain. Its utility is also valuable when follow-up scans are performed to determine the progression of cerebral change.
Authors:
Vinod V Narla; Ashok Muthukrishnan; James M Mountz
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  33     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-22     Completed Date:  2008-09-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  531-4     Citation Subset:  IM    
Affiliation:
Department of Radiology, Division of Nuclear Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain Diseases / diagnosis*
Demyelinating Diseases / diagnosis*
Female
Humans
Magnetic Resonance Spectroscopy*
Mitochondrial Diseases / diagnosis*
Protons / therapeutic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Protons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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