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Lookup NU author(s): Professor Raj KalariaORCiD
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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a genetically transmitted cerebrovascular disease. Typically, the first clinical manifestation is migraine and the full clinical spectrum of the disease with recurrent strokes of the subcortical type, cognitive, and mood disorders is seen during the fourth and fifth decades of life. Vascular risk factors are usually absent in CADASIL patients and the diagnosis of the disease is particularly suspected in young adults with cerebrovascular events of unknown cause, diffuse leukoencephalopathy on computed tomography or magnetic resonance imaging, and a history of cerebrovascular diseases or dementia in many family members. We describe three Italian CADASIL patients who presented to medical attention for cerebrovascular events occurred after the age of 55 and had, in addition to hypertension and hyperlipidemia, thrombophilic risk factors such as hyperhomocysteinemia, elevated levels of lipoprotein(a), and antiphospholipid antibodies. Symptoms possibly related to cortical involvement, such as dysphasia and visual field deficits, were reported by two of these patients. We conclude that a diagnosis of CADASIL should not be disregarded in patients with vascular risk factors and presenting with symptoms not immediately referable to subcortical damage at ages more advanced than commonly reported.
Author(s): Pantoni L, Sarti C, Pescini F, Bianchi S, Bartolini L, Nencini P, Basile AM, Lamassa M, Kalaria RN, Dotti MT, Federico A, Inzitari D
Publication type: Article
Publication status: Published
Journal: European Journal of Neurology
Year: 2004
Volume: 11
Issue: 11
Pages: 782-787
ISSN (print): 1351-5101
ISSN (electronic): 1468-1331
Publisher: Wiley-Blackwell
URL: http://dx.doi.org/10.1111/j.1468-1331.2004.00915.x
DOI: 10.1111/j.1468-1331.2004.00915.x
PubMed id: 15525301
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