Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a genetic disorder caused by mutation in mitochondrial DNA. Patients with stroke-like episodes show restrictive lesions in diffusion weighted image, whereas magnetic resonance angiography images show both vasodilation or vasoconstriction. Vasodilation may lead to hyperperfusion and cerebral edema, which may worsen clinical outcome. Here, we report a 25-year-old male patient diagnosed as MELAS, who presented with stroke-like episodes and seizures and showed cerebral edema with vasodilation which was normalized after steroid treatment.

Neuro-Behcet’s disease (NBD) is defined as neurological involvement in Behcet’s disease. A 32-year-old man was admitted due to sudden memory impairment and had a history of recurrent oral/genital ulcers. Brain magnetic resonance imaging (MRI) revealed ischemic lesions in the bilateral fornix and left thalamus, and high-resolution vessel wall MRI demonstrated vasculitis in the anterior communicating artery. We report a rare case of NBD that presented as vasculitis and ischemic stroke in the bilateral fornix and thalamus.