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CADASIL (CT only)

Case contributed by Frank Gaillard
Diagnosis almost certain

Patient Data

Age: 55 years
Gender: Male
ct

Extensive confluent deep and subcortical cerebral white matter hypo-attenuating changes involving the temporal white matter and the external capsules are noted. Some of established chronic lacunar infarcts demonstrate vacuolation/cavitation. A focal cortical infarct in the lateral aspect of the right postcentral gyrus of undetermined age.

In addition there is ill-defined hypoattenuation change in the left hemi pons likely to reflect ischemic event. Mildly prominent ventricles. No extra-axial or intra-axial acute hemorrhage or collection.

Case Discussion

This patient had a confirmed diagnosis of CADASIL and demonstrates the typical temporal and external capsule dominant chronic small vessel ischemic change. 

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