KRAS p.P34Q is described in Noonan syndrome, a condition rarely associated with CM.56  KRAS p. A146 V is described in cancer but not yet in vascular diseases.57 Interestingly, KRAS is associated with distinct vascular malformations, suggesting that intra-axial vascular malformations have overlapping phenotypes, a hypothesis supported by overlapping transcriptomic profiles in single-cell analysis.58 Using VLSM and radiological follow-up, we investigated the correlations between the clinical phenotype and somatic mutations. Here, KRAS is linked to vascular malformation.