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AJNR - American Journal of Neuroradiology

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The Spatial Distribution of MR Imaging Abnormalities in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy and Their Relationship to Age and Clinical Features

Sumeet Singhal^a, Philip Rich^b and Hugh S. Markus^a

^a Department of Clinical Neuroscience, St. George’s Hospital Medical School, St. George’s Hospital, London, United Kingdom
^b Department of Neuroradiology, Atkinson Morley Neuroscience Centre, St. George’s Hospital, London, United Kingdom

View larger version (15K): [in a new window]   FIG 1. Relationship between total Scheltens score and age.

View larger version (25K): [in a new window]   FIG 2. Mean scores by age for different brain regions. A, Composite scores of total and major regions. B, Cortical regions. C, BG structures. D, Other infratentorial structures. The y axis represents the total possible score. In panel A, where this differs for different regions the percentage of maximum possible score for each regions is given. In panels B–D, where the maximum score for each region is 6, the mean score is given for each region.

View larger version (18K): [in a new window]   FIG 3. Proportion of confluent lesions by age.

View larger version (112K): [in a new window]   FIG 4. The characteristic changes in CADASIL in (A) anterior temporal change (graded 6 on the Scheltens scale) and (B) involvement of the external capsule (grade 6). There is also confluent (grade 6) involvement of parietal white matter on this section.

View larger version (109K): [in a new window]   FIG 5. MR imaging from a 33-year-old woman who had experienced classical migraine with aura since her teens, but was otherwise asymptomatic It shows how marked anterior temporal pole involvement (grade 6) (A) can occur in the presence of much lesser involvement in other white matter structures. In panel B, frontal white matter was graded as 3 and parietal as 2.

View larger version (86K): [in a new window]   FIG 6. This MR imaging illustrates involvement of the corpus callosum. This is seen on the axial scan (A), where it was graded as 3. It is better seen on the sagittal scan (B), which also shows pontine involvement.