Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), a small vessel disease, is characterized with subcortical infarcts and deep white matter hyperintensities. CADASIL is caused by mutations in NOTCH3 gene and is often overlooked and misdiagnosed. These patients generally present with migraine, stroke, transient ischemic attacks, cognitive impairment, and mood disorder symptoms to health clinics. This syndrome usually affects individuals in the fourth or fifth decade of their lives. Depression and mania were diagnosed in 20% and about 5% of these patients, respectively. The aim of this case report is to highlight bipolar clinical presentation of a quite young CADASIL case, as CADASIL is usually associated with psychiatric disorders in the elderly.
Key words: CADASIL, depression, mania