The identified variant, COL4A1:c.*33T > A, with a combined annotation dependent depletion score of 13.85, was identical to the variant reported in the previous study of cSVD.10 The variants in COL4A1 3′UTR have been reported to be causative of PADMAL,6 and patients F1-IV-2 and F1-IV-6 were diagnosed with PADMAL. Here, COL4A1 is linked to microangiopathy and leukoencephalopathy, pontine, autosomal dominant.