Cerebral autosomal dominant arteriopathy subcortical infarct leukoencephalopathy

👉🏿Migraine with the stroke like symptoms could be due to CADASIL NOTCH3 gene mutation autosomal dominant dx with blood sample.
👉🏿Migraine w aura, With recurrent strokes, cognitive impairment, psychiatric, +f/h,
👉🏿Rx secondary stroke prevention techniques, sto smoking, control BP, tPA is not contraindicated. Avoid Triptan, and Ergot preparation. Ok to use migraine preventive rx. Donepezil not effective. +/- L-Arginine.

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