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Case of the month

April 2024

  • 55-year-old patient with a long history migraine. Presents to the emergency department after developing an aura.
  • What is the diagnosis?

cadasil

Click to reveal the answer

CADASIL

  • Patient had an inherited small vessel disease genetic panel that revealed a NOTCH-3 mutation.
  • Imaging shows a severe burden of small vessel disease that involved the external and internal capsules and the temporal poles, which is not common in conventinoal small vessel disease. There were a few old lacunar infarcts (e.g., left thalamus) and a small number of microhaemorrhages.

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