MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes) pediatric patients are at a high risk of recurrent stroke-like episodes (in radiological presentation, the locations of stroke areas do not correspond to a typical brain vascular distribution); in 80% of patients, the disease is caused by mutation 3243A>G within the MT-TL1 gene. This evidence concerns the gene MT-TL1 and stroke disorder.