Fatal cerebellar hemorrhage in a patient with CARASIL

Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) is a monogenic, hereditary cerebral small vessel disease characterized by leukoencephalopathy and lacunar infarctions. The clinical manifestations are lacunar stroke, stepwise and / or progressive neurological deterioration, vascular dementia, spondylosis and premature alopecia. Intracerebral hemorrhage has been reported in only a few patients to date. We report a patient with CARASIL and fatal cerebellar hemorrhage and discuss the safety and efficacy of antiplatelets in patients with hereditary cerebral small vessel disease.