EURORAD ESR

Case 3269

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)

Author(s)
Ranschaert E*, Klazen W*, Laurens D*, Klawer J**, Timmerhuis T**
 
Patient
female, 46 year(s)
 
 
  • Published 26.08.2005
  • DOI 10.1594/EURORAD/CASE.3269
  • Section Neuroradiology
  • Case Type Clinical Cases
  • Difficulty Resident
  • Views 4216
  • Language(s)
  • Figure 1
    Diffuse Hyperintensity of White Matter (HWM)
     

    T2-weighted images showing multiple white matter areas with high signal intensity (WMH). These areas typically have increased signal intensity on intermediate, T2-weighted and FLAIR. Typically the external capsule is...

     
    Area of Interest: unknown; Imaging Technique: Diffuse Hyperintensity of White Matter (HWM);

    T2-weighted images showing multiple white matter areas with high signal intensity (WMH). The WMH predominantly occur in the subcortical areas.

     
    Area of Interest: unknown; Imaging Technique: Diffuse Hyperintensity of White Matter (HWM);
     
     
  • Figure 2
    Lacunar infarcts
     

    Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they typically appear in (a) the semiovale centre, (b) the thalamus...

     
    Area of Interest: unknown; Imaging Technique: Lacunar infarcts;

    Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they typically appear in (a) the semiovale centre, (b) the thalamus...

     
    Area of Interest: unknown; Imaging Technique: Lacunar infarcts;

    Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they can typically be found in (a) the semiovale centre, (b) the...

     
    Area of Interest: unknown; Imaging Technique: Lacunar infarcts;
     
     
  • Figure 3
    Microbleeds
     

    The basal ganglia showing several areas of microbleeds. The so-called “blooming effect” of these microbleeds is well demonstrated: focal areas of signal intensity loss on the T2-weighted images (Image 3a) clearly...

     
    Area of Interest: unknown; Imaging Technique: Microbleeds;

    The basal ganglia showing several areas of microbleeds. The so-called “blooming effect” of these microbleeds is well demonstrated: focal areas of signal intensity loss on the T2-weighted images (Image 3a) clearly...

     
    Area of Interest: unknown; Imaging Technique: Microbleeds;
     
     
  • Figure 4
    Small Lacunar Lesions (SLLs)

    The SLLs are typically demonstrated in the anterior temporal lobes. They are defined as linearly arranged groups of rounded circumscribed lesions just below the cortex at the grey matter–white matter junction, with...

     
    Area of Interest: unknown; Imaging Technique: Small Lacunar Lesions (SLL’s);
     
     
T2-weighted images showing multiple white matter areas with high signal intensity (WMH). These areas typically have increased signal intensity on intermediate, T2-weighted and FLAIR. Typically the external capsule is also, involved(arrowhead).
 
T2-weighted images showing multiple white matter areas with high signal intensity (WMH). The WMH predominantly occur in the subcortical areas.
 
Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they typically appear in (a) the semiovale centre, (b) the thalamus (black arrow), the basal ganglia (white arrow) and (c) the brainstem.
 
Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they typically appear in (a) the semiovale centre, (b) the thalamus (black arrow), the basal ganglia (white arrow) and (c) the brainstem.
 
Lacunar infarcts are isointense to cerebrospinal fluid on all sequences and therefore appear as black spots on the FLAIR sequence. With CADASIL, they can typically be found in (a) the semiovale centre, (b) the thalamus (black arrow), the basal ganglia (white arrow) and (c) the brainstem.
 
The basal ganglia showing several areas of microbleeds. The so-called “blooming effect” of these microbleeds is well demonstrated: focal areas of signal intensity loss on the T2-weighted images (Image 3a) clearly increased in size on the T2*-weighted gradient-echo images (Image 3b).
 
The basal ganglia showing several areas of microbleeds. The so-called “blooming effect” of these microbleeds is well demonstrated: focal areas of signal intensity loss on the T2-weighted images (Image 3a) clearly increased in size on the T2*-weighted gradient-echo images (Image 3b).
 
The SLLs are typically demonstrated in the anterior temporal lobes. They are defined as linearly arranged groups of rounded circumscribed lesions just below the cortex at the grey matter–white matter junction, with a signal intensity that is identical to that of the cerebrospinal fluid on all pulse sequences. Detection of SLL’s in the anterior temporal lobes in young patients is highly suggestive of the diagnosis of CADASIL.
 
 
 
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