• Junpei Kobayashi, Shoichiro Sato, Kosuke Okumura, Fumio Miyashita, Akihiko Ueda, Yukio Ando, and Kazunori Toyoda.
• Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
• J Stroke Cerebrovasc Dis. 2014 Mar 1;23(3):e241-2.

AbstractThe location of white matter lesions, especially in the anterior temporal poles (ATP), is helpful in the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We report a 49-year-old man with CADASIL who developed migraine with atypical aura, silent lacunar infarcts, and leukoencephalopathy without involvement of the ATP. The prevalence of migraine with aura in subjects with CADASIL is several times greater than that in the general population. Particularly in patients with CADASIL, the aura is often atypical (hemiplegic, basilar, or prolonged). A diagnosis of CADASIL should be considered in patients with lacunar infarcts, leukoencephalopathy, and migraine with atypical aura, even in the absence of white matter lesion in the ATPs.Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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