We herewith report a case of 46 year old male with clinical features suggestive of CARASIL (Cerebral Autosomal Recessive Arteriopathy with Sub cortical Infarcts and Leucoencephalopathy). He had recurrent strokes in early age before reaching 35 years. He was normotensive and had severe degenerative changes in lumbar spine and knee joint on radiographs and had diffuse alopecia. Neuroimaging revealed diffuse hyperintense lesions in cerebral white matter and basal ganglia on MR images.
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