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. 2022 Mar 30;12(4):861. doi: 10.3390/diagnostics12040861

Figure 4.

Figure 4

Eleven-year-old male with new onset seizures and history of multiple stroke-like episodes attributed to mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). (a) Axial T2WI and (b) axial DWI at the level of the midbrain show nonterritorial cortical/subcortical edema/swelling in the left occipito-temporal region involving both middle and posterior cerebral artery territories consistent with acute metabolic injury (white arrows). Volume loss, T2 prolongation, and facilitated diffusion consistent with encephalomalacia from old metabolic injury is noted in the right occipito-temporal region (red arrows).