We present three mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) patients showing cerebral arterial and venous MRI abnormalities. Reversible lateralized (to the stroke-like episode) cerebral artery dilatation during the stroke-like episode was observed in two patients on TOF imaging and in one patient on SWI (Fig. 1). The first two patients also showed abnormal cortical veins, stable during and between stroke-like episodes, outside stroke-like episode areas (Fig. 1).
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