A very cautious interpretation of neuroimaging findings is important in order to identify cases of cavernous malformations, malignancies such as central nervous system lymphoma, diffuse axonal injuries, radiation-induced cerebral vasculopathy, genetic disorders including cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and COL4A1 gene mutations [37,38,39,40,41,42]. The gene discussed is COL4A1; the disease is primary central nervous system lymphoma.