Imaging characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL)

MRI of three different patiens from one family (mother, son, doughter). a) axial T2-weighted image shows characteristic changes in CADASIL - anterior temporal pole hyperintensities; b,d,g) axial T2-weighted images show periventricular hyperintensities; f) coronal T2-weighted image shows periventricular hyperintensities; c,e,h) axial T2-weighted images show hyperintensities in the deep white matter.
MRI of three different patiens from one family (mother, son, doughter). a) axial T2-weighted image shows characteristic changes in CADASIL - anterior temporal pole hyperintensities; b,d,g) axial T2-weighted images show periventricular hyperintensities; f) coronal T2-weighted image shows periventricular hyperintensities; c,e,h) axial T2-weighted images show hyperintensities in the deep white matter.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is an autosomal dominant vascular disorder. Diagnosis and follow-up in patients with CADASIL are based mainly on magnetic resonance imaging (MRI). MRI shows white matter hyperintensities (WMHs), lacunar infarcts and cerebral microbleeds (CMBs). WMHs lesions tend to be symmetrical and bilateral, distributed in the periventricular and deep white matter. The anterior temporal lobe and external capsules are predilection sites for WMHs, with higher specificity and sensitivity of anterior temporal lobe involvement compared to an external capsule involvement. Lacunar infarcts are presented by an imaging signal that has intensity of cerebrospinal fluid in all MRI sequences. They are localized within the semioval center, thalamus, basal ganglia and pons. CMBs are depicted as focal areas of signal loss on T2 images which increases in size on the T2*-weighted gradient echo planar images (“blooming effect”).

This review was published as:

Dragan Stojanov, Aleksandra Aracki-Trenkic, Slobodan Vojinovic, Srdjan Ljubisavljevic, Daniela Benedeto-Stojanov, Aleksandar Tasic, and Sasa Vujnovic. Imaging characteristics of cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL). Bosn J Basic Med Sci. 2015 Feb; 15(1): 1–8. doi:  10.17305/bjbms.2015.247

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