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Click 48 year old female with acute symptomatic Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Axial FLAIR sequences demonstrating confluent near symmetric bihemispheric subcortical increased white matter T2 hyperintense signal in the temporal lobes, extreme capsules and the subcortical white matter, typical for CADASIL (1.5 Tesla magnet, TR 8.000, TE 127.30, NEX 1.5, Flip 160.15, slice thickness 5mm).

Click 48 year old female with acute symptomatic Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Axial diffusion sequences demonstrating bihemispheric multiple foci of increased signal distributed in a typical peri-ventricular pattern compatible with acute watershed infarcts. Additionally identified is an acute punctate infarction in the superficial perforator territory. (1.5 Tesla magnet, TR 8,600, TE 74.50, NEX 1.0, Flip 90, slice thickness 5mm).

Click 48 year old female with acute symptomatic Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Axial ADC mapped sequences demonstrating multiple foci of true restricted diffusion decreased signal distributed in a typical peri-ventricular pattern compatible with acute watershed infarcts, corresponding to the abnormalities identified by diffusion weighted imaging. Additionally identified is an acute punctate signal loss related to punctuate infarction in the superficial perforator territory. (1.5 Tesla magnet, TR 8,600, TE 74.50, NEX 1.0, Flip 90, slice thickness 5mm).

Click 48 year old female with acute symptomatic Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Qualitative assessment of perfusion MRI imaging demonstrates bihemispheric decreased cerebral blood flow increased mean transit time and decreased cerebral blood volume. Normal range delineated by white bar. ( 1.5 Tesla magnet, Echo Planar Imaging, TR 2000, TE 13.20, NEX1, Flip 60, Slice thickness 5 mm, Dynamic imaging performed before, during and after a single 0.2mmol/kg dose Multihance (Gadobenate dimeglumine, Bracco Diagnostics, Princeton, NJ) power injection at a rate of 4 cc/s. The arterial input function to calculate perfusion parameters determined from the middle cerebral artery. Calculation of relative CBF, CBV and MTT from multiple regions of interest placed within the corona radiata regions bilaterally.