CADASIL

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Repeated neurological events in a 60 year old female with a family history stroke, depression and dementia.

Patient Data

Age: 60 years
Gender: Female
mri
This study is a stack
Sagittal
T1
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
DWI
This study is a stack
MRA
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Info

Widespread small vessel ischemic changes with involvement of the temporal lobes

CADASIL Genetic Test

GENE TESTED: Notch 3 for CADASIL

RESULTS:    Positive mutation for Notch 3 gene. This is a previously reported CADASIL mutation in exon 3.

Case Discussion

This case demonstrates fairly typical distribution of ischemic changes in a patient with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Note the prominent involvement of the temporal poles, which are usually relatively spared in run-of-the-mill chronic small vessel ischemic change. 

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