Vascular parkinsonism and dementia in a CADASIL case with intact nigrostriatal dopaminergic system

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukencephalopathy (CADASIL) is responsible for up to 5% of cerebral small vessel diseases manifesting mostly between the age of 40 and 60 years irrespective of vascular risk factors. The clinical spectrum includes migraine, recurrent subcortical strokes, cognitive decline with a subcortical type of dementia, and mood disorders as the most frequent psychiatric manifestations. A 55-year old male presented to our department with a two year history of progressive immobility, cognitive decline, and urinary incontinence. On examination, the patien…