Clinical, Radiological, and Outcome Parameters of CADASIL from India: Findings from a Multicentric Case Series

ABSTRACT: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary monogenic cause of cerebral small vessel disease with a heterogeneous clinical spectrum. Published literature data from India remain limited. We conducted a multicentric, ambispective review of genetically proven CADASIL cases between 2021 and 2025 to describe the clinical, neuroimaging, and outcome profiles of CADASIL from a multicentric case series from India. A total of 13 patients were included, with a mean age of 47 years and a marked male predominance (84.6%). Motor weakness (69.2%) and dysarthria (53.8%) were the most frequent manifestations. Neuroimaging revealed infarcts in all cases, while hemorrhagic involvement in the form of microbleeds on susceptibility-weighted imaging was noted in 5 patients (38.5%). The majority of patients (61.5%) were managed with antiplatelet agents and statins. Follow-up data at one year were available for 8 patients, all of whom experienced recurrent stroke events.