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Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a rare hereditary disease characterised by ischaemic cerebral white matter lesions, spondylosis and alopecia.1 2 Like cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), CARASIL is caused by abnormalities of a single gene. The causative gene has been recently identified as HTRA1.3 The white matter lesions, which result from non-hypertensive small-vessel arteriopathy, appear in early adulthood,1 3 but their association with neurological manifestations is poorly understood.
A 37-year-old woman visited our hospital due to her inability to stand without assistance. The deep tendon reflexes in her lower limbs were brisk and there was mild muscle weakness in the proximal lower extremities. An MRI revealed diffuse subcortical white matter lesions. Her Mini-Mental State Examination score was 27/30, which was within …
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