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Topics:
Neurology • Vascular Neurology
How do you evaluate and manage patients with recurrent multifocal subcortical ischemic infarcts of unclear etiology?
What potential etiologies would you consider in this case, and what corresponding diagnostic workup would be appropriate to evaluate them?
Answer from: at Academic Institution
Presuming the search for a large vessel or cardiac source was negative, I would assume the cause is small vessel disease. To reduce the risk of recurrence, vascular risk factors such as hypertension and elevated cholesterol should be maximally controlled. An antiplatelet drug should also be used, ei...
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Answer from: at Community Practice
Agree with above. Also, within the right clinical context (migraine headaches with aura, memory loss, young age), I would consider the diagnosis of CADASIL and check for a NOTCH3 mutation.