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Cerebral microbleeds in CADASIL.

S A Lesnik Oberstein1, R van den Boom, M A van Buchem

  • 1Department of Clinical Genetics, Leiden University Medical Center, Rijnland Hospital, Leiden, the Netherlands. lesnik@lumc.nl

Neurology
|September 26, 2001
PubMed
Summary
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Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients show an increased risk of age-related cerebral microbleeds. This finding suggests a higher potential for intracerebral hemorrhage (ICH) in CADASIL, impacting diagnosis and management.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy causing recurrent strokes and dementia.
  • Intracerebral hemorrhage (ICH) is occasionally reported in CADASIL, but the propensity for microbleeding remains uncharacterized.

Purpose of the Study:

  • To investigate the presence and prevalence of cerebral microbleeds in individuals with CADASIL.
  • To determine if cerebral vessels in CADASIL patients are susceptible to microbleeding.

Main Methods:

  • Utilized T2*-weighted gradient echo MRI, a sensitive technique for detecting microbleeds, in 63 CADASIL patients and family members.
  • Assessed known risk factors for ICH and correlated microbleed presence with demographic, clinical, and genetic variables.

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Main Results:

  • Cerebral microbleeds were identified in 31% of symptomatic CADASIL mutation carriers, primarily in the thalamus.
  • Microbleed occurrence was associated with age, disability score, antiplatelet use, lacunar lesions, and the Arg153Cys Notch3 mutation.
  • After adjusting for age, the Arg153Cys mutation remained the sole significant predictor of microbleeds.

Conclusions:

  • CADASIL patients exhibit an age-dependent increase in the risk of intracerebral microbleeds.
  • The findings suggest an elevated risk for ICH in CADASIL, necessitating consideration in clinical practice.
  • Early detection and management strategies for microbleeds are crucial for CADASIL patient care.