Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) During Pregnancy: Case Report and Review of the Literature

Abstract

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts leukoencephalopathy (CADASIL) is a hereditary disease characterized by early adult-onset of neurologic manifestations such as migraine, dementia, and stroke. The prevalence of CADASIL is 4.15 per 100 000 adults. Pregnancy and puerperium are associated with worsening of symptoms. Case: We present a 31-year-old G3P0020 patient with a pre-pregnancy diagnosis of CADASIL followed during pregnancy and postpartum period. The patient had a strong family history of CADASIL as well as neurologic symptoms of headaches and vision changes. The patient was started on aspirin and her pregnancy was managed by a multidisciplinary team. She was admitted at 34 weeks for an evaluation of severe headaches and lower limb weakness. She had an uncomplicated cesarean delivery at 39 weeks and an uncomplicated postpartum period.