COL4A1 and microangiopathy and leukoencephalopathy, pontine, autosomal dominant: While certain risk factors of PADMAL have not been established yet, sporting activities with a high risk of head trauma or prolonged exercise are considered to be avoided for patients with COL4A1/2 variants..5 Therefore, if we can detect patients with PADMAL more precisely, we would be able to recognize higher risks of recurrent brain infarctions with them.