Author: Sam Killian, MD

Educational Pearls:

• Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) occurs in 1:100000 individuals
• The disease is caused by a defect in the NOTCH3 gene on chromosome 19
• It is an important cause of stroke in young patients
• Features include ischemia, cognitive deficits, migraines, psychiatric disease, coma, and seizure, all of which is worse with pregnancy
• Migraine with aura is often the first presenting symptom with onset by age 30
• Strokes typically can occur by age 50
• Diagnosis is with MRI for characteristic lesions
• Unfortunately there is no cure, and treatment is focused on stroke prevention with aspirin and statins

References:

Chabriat H, Joutel A, Dichgans M, Tournier-Lasserve E, Bousser MG. Cadasil. Lancet Neurol. 2009 Jul;8(7):643-53. doi: 10.1016/S1474-4422(09)70127-9. Review. PubMed PMID: 19539236.

Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD