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FROM HEADACHE TO BINSWANGER
We present the case of a 66-year old female, with hypertension, who presents headache for about 1 year, emotional unsteadiness, and anxious states. Clinical examination revealed nystagmus, upper limb dysmetry, and has a MMSE score of 26 points. Brain MRI emphasized multiple hyperintense lesions on T2 sequences distributed supratentorially, and affecting the cerebral white matter. The differential diagnosis was established between Binswanger disease (subcortical atherosclerotic encephalopathy) and CADASIL syndrome (cerebral autosomal dominant encephalopathy with subcortical infarcts and leucoencephalopathy. The last was ruled out because the patient had no family history of such syndrome.
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