Epidural management for obstetric patient with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) undergoing emergent cesarean section

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare, autosomal dominant disorder that results from mutations of the NOTCH 3 gene on chromosome 19. The resultant dysfunctional NOTCH 3 protein leads to impaired cerebrovascular autoregulation. CADASIL is characterized by recurrent subcortical ischemic infarcts that can lead to migraine, with or without aura; cognitive problems; seizures; psychiatric symptoms; dementia; walking difficulties; and urinary incontinence [1].

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