%0 Case Reports
%T Vascular cognitive impairment associated with NOTCH3 Exon 33 mutation: A case report.
%A Sun Y
%A Wei YJ
%A Xing Y
%J Medicine (Baltimore)
%V 98
%N 34
%D Aug 2019
%M 31441874
%F 1.817
%R 10.1097/MD.0000000000016920
%X <B>BACKGROUND: </B>Vascular cognitive impairment (VCI) is a common cause of dementia. Research suggests that hereditary factors (gene mutations) play an important role in the pathogenesis of VCI, and a mutation of the NOTCH3 locus is frequently identified in affected patients. Herein, we report the case of a patient with confirmed VCI associated with a NOTCH3 exon 33 gene mutation and review the relevant VCI literature.<BR><B>UNASSIGNED: </B>A 48-year-old man presented to our neurology clinic with gradually progressive cognitive impairment.<BR><B>UNASSIGNED: </B>Brain magnetic resonance imaging revealed multiple punctate hyperintensities in the patient's periventricular white matter. Genetic analysis showed a c.6744C > T, p. Ala2223Val substitution in exon 33 of the NOTCH3 gene. We diagnosed thepatient with VCI secondary to a NOTCH3 gene mutation.<BR><B>METHODS: </B>Donepezil (5 mg) and memantine (5 mg) daily.<BR><B>RESULTS: </B>The patient showed symptom improvement at his 3-month and 6-month follow-up appointments.<BR><B>CONCLUSIONS: </B>This patient may have a new type of mutation that is different from the one seen in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, although it involves a NOTCH3 defect. We propose that the entire NOTCH3 gene should be sequenced in patients with suspected hereditary VCI. This practice could facilitate the discovery of newpathogenic mutations and diseases.