title: Spontaneous intracerebral hemorrhage in CADASIL.
abstract: BACKGROUND
  Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare hereditary small vascular disease and its mainly clinical manifestations are ischemic events. Spontaneous intracerebral hemorrhage (ICH) involvement in patients with CADASIL is extremely uncommon.
  
  
  METHODS
  A 46-year-old normotensive Chinese man developed a large hematoma in the left basal ganglia after he was diagnosed with CADASIL 2 months ago, the patient did not take any antithrombotics. Susceptibility weighted imaging at pre-ICH showed multiple cerebral microbleeds (CMBs) in the bilateral basal ganglia. He experienced migraine at about 10 months post-ICH. To our knowledge, this is the first report of ICH in CADASIL patients with Arg90Cys mutation in exon 3.
  
  
  CONCLUSIONS
  ICH should be considered when evaluating new attacks in CADASIL patients. Thus, MRI screening for CMBs might be helpful in predicting the risk of ICH and guiding antithrombotic therapy. In addition, strict control of hypertension and cautious use of antithrombotics may be important in this context.
authors.forename: Lifei
authors.initials: L
authors.lastname: Lian
authors.forename: Dujuan
authors.initials: D
authors.lastname: Li
authors.forename: Zheng
authors.initials: Z
authors.lastname: Xue
authors.forename: Qiming
authors.initials: Q
authors.lastname: Liang
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.forename: Huicong
authors.initials: H
authors.lastname: Kang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, Hubei 430030, P,R, China. zhusuiqiang@gmail.com.
authors.forename: Suiqiang
authors.initials: S
authors.lastname: Zhu
mesh_terms: D046589:CADASIL / Q000150:complications* / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged