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The related main theme: A. Stroke and Cerebral vascular disorders

CADASIL病人之栓子性腦中風

EMBOLIC STROKE IN A CADASIL PATIENT

Authers:

洪于珺,  1 , 連立明,   , 
Yu-Jyun  Hong,  1 , Li-Ming  Lien,   , 
1 新光吳火獅紀念醫院
1 Shin Kong Wu Huo-Shih Memorial Hospital
Corresponding Author:

連立明
Li-Ming  Lien , 
新光吳火獅紀念醫院
Shin Kong Wu Huo-Shih Memorial Hospital

keywords: CADASIL, embolic stroke, cortical infarction
Abstract for case report

CASE REPORT:
A 47-year-old CADASIL patient presented to our emergency department with an acute onset of left hemiparesis. MRI of the brain demonstrated multiple small cortical infarcts in both cerebral hemispheres. Carotid ultrasonography was normal. The detailed coagulation profile and autoimmune serology were unremarkable. Transthoracic and transesophageal echocardiography revealed normal valves and no evidence of intracardiac thrombi or other cardiac anomalies. No arrhythmias were detected on the long-term ECG monitoring. The work-up for malignancy including tumor markers and whole-body PET scan showed results within normal limits. Despite extensive diagnostic work-up, no embolic sources were identified. The patient was eventually diagnosed with embolic stroke of undetermined source.

DISCUSSION:
CADASIL is an inherited small-vessel disease, with one of its typical features being subcortical lacunar lesions localizing within the centrum semiovale, thalamus, basal ganglia, and pons. In summary, we have described an unusual case of CADASIL presenting with multiple acute cortical infarcts. No convincing evidence of an embolic source was disclosed in our investigations.


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