Finsterer Josef
Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria.
Medicine (Baltimore). 2020 Feb;99(8):e19141. doi: 10.1097/MD.0000000000019141.
Stroke-like episodes (SLEs) are typical cerebral manifestations of certain mitochondrial disorders (MIDs). They are characterised by a vasogenic edema in a non-vascular distribution. PATIENTS CONCERNS:: none DIAGNOSIS:: SLEs show up on cerebral MRI as stroke-like lesions (SLLs), characterised by vasogenic edema in a non-vascular distribution. SLLs expand in the acute stage and regress during the chronic stage. They show hyperperfusion in the acute stage and hypoperfusion in the chronic stage.
SLLs respond favorably to antiseizure drugs, to No-precursors, steroids, the ketogenic diet, and antioxidants.
SLLs end up as normal tissue, white matter lesion, grey matter lesion, cyst, laminar cortical necrosis, or the toenail sign.
SLLs are a frequent manifestation of MIDs. They undergo dynamic changes in the acute and chronic stage. They need to be differentiated from ischemic stroke as they are differentially treated.
类卒中发作（SLEs）是某些线粒体疾病（MIDs）典型的脑部表现。其特征为非血管分布区域的血管源性水肿。
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SLEs在脑部磁共振成像（MRI）上表现为类卒中病灶（SLLs），其特征为非血管分布区域的血管源性水肿。SLLs在急性期扩大，在慢性期消退。它们在急性期表现为灌注增强，在慢性期表现为灌注减低。
SLLs对抗癫痫药物、一氧化氮前体、类固醇、生酮饮食和抗氧化剂反应良好。
SLLs最终转归为正常组织、白质病变、灰质病变、囊肿、层状皮质坏死或甲征。
SLLs是MIDs的常见表现。它们在急性期和慢性期会发生动态变化。由于治疗方法不同，需要将它们与缺血性卒中相鉴别。
