Knowledge about the characteristics of stroke-like lesions is expandable.

Stroke-like episodes (SLEs) are a common phenotypic feature of various syndromic and non-syndromic mitochondrial disorders (MIDs), particularly of mitochondrial encephalopathy, lactic acidosis, and stroke-like episode syndrome (MELAS). The morphological equivalent of a SLE is the stroke-like lesion (SLE), a dynamic lesion, which initially expands to regress after weeks or months. SLLs present with typical morphological and structural abnormalities on multimodal magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), and FDG-PET. It is crucial to clearly delineate SLLs from ischemic stroke, as treatment and outcome vary significantly between the two.