Diagnosing CADASIL using MRI: evidence from families with known mutations of Notch 3 gene

S J Chawda, R P J De Lange, M D Hourihan, S F S Halpin, D St Clair

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20 Citations (Scopus)

Abstract

Clinical data and MRI findings are presented on 18 subjects from two families with neuropathologically confirmed CADA-SIL. DNA analysis revealed mutations in exon 4 of Notch 3 gene in both families. All family members with mutations in Notch 3 gene had extensive abnormalities on MRI, principally lesions in the white matter of the frontal lobes and in the external capsules. Of several family members in whom a diagnosis of CADASIL was suspected on the basis of minor symptoms, one had MRI changes consistent with CADASIL; none of these cases carried a mutation in the Notch 3 gene. MRI and clinical features that may alert the radiologist to the diagnosis of CADASIL are reviewed. However, a wide differential diagnosis exists for the MRI appearances of CADASIL, including multiple sclerosis and small-vessel disease secondary to hypertension. The definitive diagnosis cannot be made on MRI alone and requires additional evidence, where available, from a positive family history and by screening DNA for mutations of Notch 3 gene.

Original languageEnglish
Pages (from-to)249-255
Number of pages7
JournalNeuroradiology
Volume42
Publication statusPublished - 2000

Keywords

  • cerebral autosomal dominant arteriopathy magnetic resonance imaging
  • AUTOSOMAL-DOMINANT ARTERIOPATHY
  • MULTI-INFARCT DEMENTIA
  • SURAL NERVE BIOPSY
  • SUBCORTICAL INFARCTS
  • LEUKOENCEPHALOPATHY CADASIL
  • SPECTRUM
  • MIGRAINE
  • LESIONS
  • STROKE
  • MUSCLE

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