An Unusual Cause of Stroke-Like Symptoms in an Elderly Patient

Major cerebral vessels involvement in patients with MELAS syndrome: Worth a scan? A systematic review

“…Among patients studied with CTA (n = 6), one patient presented dilation, 22 two presented stenosis, 18,37 one both stenosis and dilation, 34 and two normal examinations. 27,36 Five studies reported CTA and MRA findings, showing in all cases the same results. 18,22,27,34,36 We found only a case report of a 47-year-old MELAS patient that was studied with CTA alone that reported stenosis of both ICAs.…”

“…27,36 Five studies reported CTA and MRA findings, showing in all cases the same results. 18,22,27,34,36 We found only a case report of a 47-year-old MELAS patient that was studied with CTA alone that reported stenosis of both ICAs. 37 This patient was found to have a bilateral chronic dissection of carotid arteries that subsequently became symptomatic for acute ischemic stroke due to occlusion of both MCAs in addition to a suspected arterio-arterial thromboembolism.…”

“…No iconographic images were reported in these studies. 16,25,27,29,30,32,33,35,36 Computed tomographic angiography (CTA) results…”

“…Only two (9%) studies systematically evaluated samples of MELAS patients with brain MRA, 20,21 while the remaining 21 studies (91%) were case reports. [16][17][18][19][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The majority of studies utilized MRA (21/23, 91%), 5 studies used CTA (22%) 18,22,27,34,36 and 5 studies used DSA (22%) in addition to MRA. 18,28,30,31,33 One study was performed with CTA alone, 37 and one study was performed with DSA alone.…”