Her two sisters were diagnosed with a probable CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), but with no mutation in NOTCH3. One of the sisters suffered from dementia and was diagnosed with disseminated and diffuse changes in brain MRI interpreted as the beginning of demyelination (she died at the age of 60 years, and no medical records were available). Here, NOTCH3 is linked to Leukoencephalopathy.