id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-330063-rigpx36k	Williams, Owain Hedd	Multiple internal border zone infarcts in a patient with COVID-19 and CADASIL	2020-06-09		.txt	text/plain	1201	72	35	• Novel case report highlighting association of COVID-19 precipitating symptoms of CADASIL; • Multiple internal border zone infarcts in a patient with COVID-19 and CADASIL; • Proposed mechanism is endothelial injury with microvascular thrombosis and cerebral dysautoregulation; • We advise to consider patients with CADASIL a vulnerable group during the pandemic. (1) An association between COVID-19 and strokes have been described with characteristics including large vessel occlusion, multi-territory infarcts, concomitant venous thromboembolism, raised inflammatory markers, antiphospholipid antibody production, younger age of stroke, premorbid vascular co-morbidities, and a higher incidence of stroke with increasing COVID-19 severity.(2-4) Small vessel involvement have rarely been described; our case demonstrates multiple internal border zone infarcts, which are subcortical lesions at the junction between two arterial territories, typically attributed to haemodynamic compromise. There is evidence of chronic cerebral hypoperfusion in CADASIL, with a proposed mechanism being impairment in the myogenic component of autoregulation where vascular smooth muscle constricts or dilates to transmural pressure changes.(1) Internal border zone infarcts have been reported in nine patients with CADASIL; whereby six had documented systemic hypotension, one occurring with intercurrent Influenza A infection.	./cache/cord-330063-rigpx36k.txt	./txt/cord-330063-rigpx36k.txt