BACKGROUND AND PURPOSE: Recently COL4A1, a gene encoding the type IV collagen alpha1 chain, has been found to be involved in families with autosomal-dominant porencephaly and infantile hemiparesis. In addition to neonatal stroke, some family members had experienced, during adulthood, spontaneous intracerebral hemorrhages (ICHs) and leukoencephalopathy, suggestive of underlying small-vessel disease of the brain. We now report a patient with sporadic, recurrent ICHs and a novel COL4A1 mutation. METHODS: We performed a clinical and genetic study of a 25-year-old-patient with an 8-year history of recurrent ICHs. RESULTS: This young, normotensive patient with a history of infantile hemiparesis had experienced, since the age of 17, recurrent, spontaneous, deep ICHs occurring during sports activities. He became severely disabled. Brain magnetic resonance imaging showed ventricular enlargement, diffuse white-matter abnormalities, and newly appearing, deep, silent microbleeds. Extensive investigations found no cause. There was no family history of stroke or infantile hemiparesis. A novel COL4A1 mutation (G805R) was identified. CONCLUSIONS: The clinical spectrum of COL4A1 mutations includes recurrent ICHs in association with diffuse leukoencephalopathy in young adults, even in the absence of a family history of infantile hemiparesis or ICH. In addition to birth trauma, anticoagulant use, and head trauma previously reported, sports activities may be a precipitating factor of ICHs in persons with COL4A1 mutations.
BACKGROUND AND PURPOSE: Recently COL4A1, a gene encoding the type IV collagen alpha1 chain, has been found to be involved in families with autosomal-dominant porencephaly and infantile hemiparesis. In addition to neonatal stroke, some family members had experienced, during adulthood, spontaneous intracerebral hemorrhages (ICHs) and leukoencephalopathy, suggestive of underlying small-vessel disease of the brain. We now report a patient with sporadic, recurrent ICHs and a novel COL4A1 mutation. METHODS: We performed a clinical and genetic study of a 25-year-old-patient with an 8-year history of recurrent ICHs. RESULTS: This young, normotensive patient with a history of infantile hemiparesis had experienced, since the age of 17, recurrent, spontaneous, deep ICHs occurring during sports activities. He became severely disabled. Brain magnetic resonance imaging showed ventricular enlargement, diffuse white-matter abnormalities, and newly appearing, deep, silent microbleeds. Extensive investigations found no cause. There was no family history of stroke or infantile hemiparesis. A novel COL4A1 mutation (G805R) was identified. CONCLUSIONS: The clinical spectrum of COL4A1 mutations includes recurrent ICHs in association with diffuse leukoencephalopathy in young adults, even in the absence of a family history of infantile hemiparesis or ICH. In addition to birth trauma, anticoagulant use, and head trauma previously reported, sports activities may be a precipitating factor of ICHs in persons with COL4A1 mutations.
Authors: Marine Poittevin; Pierre Lozeron; Rose Hilal; Bernard I Levy; Tatiana Merkulova-Rainon; Nathalie Kubis Journal: Transl Stroke Res Date: 2013-11-22 Impact factor: 6.829
Authors: Robin Lemmens; Alessandra Maugeri; Hans W M Niessen; An Goris; Thomas Tousseyn; Philippe Demaerel; Anniek Corveleyn; Wim Robberecht; Marjo S van der Knaap; Vincent N Thijs; Petra J G Zwijnenburg Journal: Hum Mol Genet Date: 2012-10-12 Impact factor: 6.150
Authors: S Alamowitch; E Plaisier; P Favrole; C Prost; Z Chen; T Van Agtmael; B Marro; P Ronco Journal: Neurology Date: 2009-12-01 Impact factor: 9.910