{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T18:24:12Z","timestamp":1758479052254},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2009,2]]},"abstract":"\n \n Background and Purpose\u2014<\/jats:italic>\n <\/jats:bold>\n Most diffusion MRI studies of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episode stroke-like lesions report high- or normal-apparent diffusion coefficient, and this has been used to differentiate stroke-like lesion from ischemic stroke. There are, however, 3 recent reports of restricted diffusion in the acute phase of the stroke-like lesions. The purpose of our study was to investigate this apparent paradox.\n <\/jats:p>\n \n \n Methods\u2014<\/jats:italic>\n <\/jats:bold>\n We performed 9 serial MRI covering 2 stroke-like episodes in a 36-year-old man with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episode caused by the common mitochondrial DNA mutation\n 3243A>G<\/jats:italic>\n .\n <\/jats:p>\n \n \n Results\u2014<\/jats:italic>\n <\/jats:bold>\n We found clear evidence of initial restricted diffusion in the stroke-like lesions, which gradually evolved to high-apparent diffusion coefficient as lesions aged. Evolution was, however, asynchronous with both high- and low-apparent diffusion coefficients temporally coexisting.\n <\/jats:p>\n \n \n Conclusions\u2014<\/jats:italic>\n <\/jats:bold>\n Our findings suggest that cytotoxic edema does occur early in the course of a stroke-like lesions and that its presence or, conversely, the absence of vasogenic edema, should not weaken the possibility of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episode in favor of ischemic stroke.\n <\/jats:p>","DOI":"10.1161\/strokeaha.108.523118","type":"journal-article","created":{"date-parts":[[2008,12,19]],"date-time":"2008-12-19T02:40:49Z","timestamp":1229654449000},"update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":43,"title":["Serial Diffusion Imaging in a Case of Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-Like Episodes"],"prefix":"10.1161","volume":"40","author":[{"given":"Charalampos","family":"Tzoulis","sequence":"first","affiliation":[{"name":"From Department of Neurology (C.T., L.A.B.), Haukeland University Hospital, Bergen Norway; Department of Clinical Medicine (C.T., L.A.B.), University of Bergen. Bergen, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence A.","family":"Bindoff","sequence":"additional","affiliation":[{"name":"From Department of Neurology (C.T., L.A.B.), Haukeland University Hospital, Bergen Norway; Department of Clinical Medicine (C.T., L.A.B.), University of Bergen. Bergen, Norway."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.2174\/1567202052773544"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002340000335"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wno.0000204662.25935.8b"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.wno.0000249317.81367.3d"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.16932"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.9.2182"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.69.2.248"},{"key":"e_1_3_2_8_2","first-page":"269","volume":"22","year":"2001","unstructured":"Yonemura K, Hasegawa Y, Kimura K, Minematsu K, Yamaguchi T. Diffusion-weighted MR imaging in a case of mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes. AJNR Am J Neuroradiol. 2001; 22: 269\u2013272.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(03)00218-1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-003-1029-6"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.217.2.r00nv24331"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.27.9.1648"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.108.523118","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:25:49Z","timestamp":1715603149000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.108.523118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,2]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2009,2]]}},"alternative-id":["10.1161\/STROKEAHA.108.523118"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.108.523118","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,2]]},"assertion":[{"value":"2008-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-06-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-12-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}