Viera Saly
CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopahy) is a hereditary disease of young and middle age adults of various ethnic groups and presents with migraine with aura, transient ischemic attacks, psychiatric disturbances and recurrent strokes leading to subcortical dementia. Prevalence of CADASIL in western Europe is estimated to be approximately 2-4/100 000 while only a few patients have been reported in eastern Europe and other countries. Here, we discuss possible explanations for this discrepancy from the point of view of a community neurologist, including lack of clinical and imaging diagnostic criteria, relative unavailability of genetic tests and usefulness of diagnostic skin biopsy.