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Spontaneous intracerebral hemorrhage in CADASIL.
[cadasil]
Cerebral
autosomal
dominant
arteriopathy
with
subcortical
infarcts
and
leukoencephalopathy
(
CADASIL
)
is
a
rare
hereditary
small
vascular
disease
and
its
mainly
clinical
manifestations
are
ischemic
events
.
Spontaneous
intracerebral
hemorrhage
(
ICH
)
involvement
in
patients
with
CADASIL
is
extremely
uncommon
.
A
46
-
year
-old
normotensive
Chinese
man
developed
a
large
hematoma
in
the
left
basal
ganglia
after
he
was
diagnosed
with
CADASIL
2
months
ago
,
the
patient
did
not
take
any
antithrombotics
.
Susceptibility
weighted
imaging
at
pre-
ICH
showed
multiple
cerebral
microbleeds
(
CMBs
)
in
the
bilateral
basal
ganglia
.
He
experienced
migraine
at
about
10
months
post-
ICH
.
To
our
knowledge
,
this
is
the
first
report
of
ICH
in
CADASIL
patients
with
Arg
90
Cys
mutation
in
exon
3
.
ICH
should
be
considered
when
evaluating
new
attacks
in
CADASIL
patients
.
Thus
,
MRI
screening
for
CMBs
might
be
helpful
in
predicting
the
risk
of
ICH
and
guiding
antithrombotic
therapy
.
In
addition
,
strict
control
of
hypertension
and
cautious
use
of
antithrombotics
may
be
important
in
this
context
.
Diseases
Validation
Diseases presenting
"cautious use of antithrombotics may be important in this context"
symptom
cadasil
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