NOTCH3 and Stroke: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary disease of the small blood vessels caused by mutations in the NOTCH3 gene.[1] Although the mutations are highly stereotyped, clinical phenotypes are variable, stressing the importance of studying populations of patients with specific mutations.[2] The main clinical manifestations are recurrent stroke, cognitive decline, chronic headache, mood disturbances, and seizure.[3,4] Magnetic resonance imaging (MRI) is crucial in the diagnosis of CADASIL.