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Intracerebral hemorrhage in CADASIL

P Palazzo1, G Le Guyader2, J-P Neau1

  • 1Department of Neurology, Poitiers University Hospital, 2, rue de la Milétrie, 86021 Poitiers Cedex, France.

Revue Neurologique
|January 22, 2021
PubMed

Insights

Intracerebral hemorrhage (ICH) is an uncommon manifestation of Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). This study highlights ICH characteristics in CADASIL patients, even without typical symptoms.

Area of Science:

  • Neurology
  • Genetics
  • Radiology

Background:

  • Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare genetic disorder.
  • Intracerebral hemorrhage (ICH) is infrequently observed in CADASIL, primarily in hypertensive individuals.

Purpose of the Study:

  • To investigate the clinical and radiological features of CADASIL patients experiencing intracerebral hemorrhage (ICH).

Main Methods:

  • Retrospective analysis of neuroimaging in CADASIL patients hospitalized for acute cerebrovascular events.
  • Systematic literature review on CADASIL and ICH.

Main Results:

  • A total of 52 subjects with CADASIL and ICH were reported (mean age 56).
  • Hemorrhages were predominantly deep-seated (34/52), with 3 asymptomatic cases.
  • Neuroimaging revealed extensive white matter hyperintensities, microbleeds in most patients, and lacunar infarcts in many.

Conclusions:

  • Intracerebral hemorrhage (ICH) is a potential, though rare, manifestation of CADASIL.
  • Consider ICH in patients with leukoencephalopathy and microbleeds, even without other symptoms.
Abstract

Keywords:
CADASILIntracerebral hemorrhageIntracranial hemorrhageMicrobleedsSmall vessels disease

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