Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood
Fetal alcohol spectrum disorder (FASD) encompasses a broad range of physical and neurological impairments resulting from prenatal alcohol exposure (PAE). While the neurological consequences of FASD are well documented, its potential association with vascular leukoencephalopathy (VL) remains poorly d...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | Brain Disorders |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666459325000769 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849321098552803328 |
|---|---|
| author | Julie Gallien Nadia Bouhamdani Mahée Côté Dominique Bouhamdani M'Hamed Belkhodja Nicole Leblanc Ludivine Chamard-Witkowski |
| author_facet | Julie Gallien Nadia Bouhamdani Mahée Côté Dominique Bouhamdani M'Hamed Belkhodja Nicole Leblanc Ludivine Chamard-Witkowski |
| author_sort | Julie Gallien |
| collection | DOAJ |
| description | Fetal alcohol spectrum disorder (FASD) encompasses a broad range of physical and neurological impairments resulting from prenatal alcohol exposure (PAE). While the neurological consequences of FASD are well documented, its potential association with vascular leukoencephalopathy (VL) remains poorly documented and incompletely understood. This case report presents a unique case of VL documented in a 20-year-old female diagnosed with FASD at 11 years of age, offering new insights into this underrecognized and potentially emerging association. The patient had several neurological and neurodevelopmental concerns starting in infancy, which prompted a number of brain Magnetic Resonance Imaging (MRI) scans throughout life. More recently, atypical neurological examination and comorbidities led to a referral to the neurology department to investigate a possible diagnosis of multiple sclerosis. Neurological evaluation, which included ordering a new MRI and reviewing previous scans, confirmed the presence of progressive white matter lesions suggestive of VL. Despite an extensive diagnostic workup, including genetic, metabolic, and autoimmune testing, no alternative etiology was identified. The patient’s clinical history, neurodevelopmental profile, and confirmed PAE raised the possibility of VL being associated with FASD as the most plausible explanation. This case highlights the potential vascular consequences of PAE, including disrupted angiogenesis, cerebral hypoperfusion, and increased blood-brain barrier permeability, mechanisms that mirror those seen in VL. As such, it emphasizes the importance of recognizing this possible association in a clinical setting. Early neuroimaging in FASD patients may facilitate timely detection of subclinical vascular pathology, guide treatment strategies, and help mitigate long-term neurological risks. Documenting such cases is crucial to expanding clinical awareness and supporting future research. |
| format | Article |
| id | doaj-art-b4366faf09884fb7b99a262e8f59bf76 |
| institution | Kabale University |
| issn | 2666-4593 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain Disorders |
| spelling | doaj-art-b4366faf09884fb7b99a262e8f59bf762025-08-20T03:49:50ZengElsevierBrain Disorders2666-45932025-09-011910025710.1016/j.dscb.2025.100257Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understoodJulie Gallien0Nadia Bouhamdani1Mahée Côté2Dominique Bouhamdani3M'Hamed Belkhodja4Nicole Leblanc5Ludivine Chamard-Witkowski6Centre de Formation médicale du Nouveau-Brunswick, 50 de la Francophonie St, Moncton, NB E1A 7R1, Canada; Université de Sherbrooke, Department of family medicine and emergency medicine. 3001, 12e avenue Nord, Sherbrooke, QC. J1H 5N4, Canada; Corresponding author at: Medical Student at Sherbrooke University.Université de Sherbrooke, Department of family medicine and emergency medicine. 3001, 12e avenue Nord, Sherbrooke, QC. J1H 5N4, Canada; Vitalité Health Network, 330 University Ave., Moncton, NB E1C 2Z3, Canada; Université de Moncton, Departement of chemistry and biochemistry, Moncton NB, E1C 2Z3Centre de Formation médicale du Nouveau-Brunswick, 50 de la Francophonie St, Moncton, NB E1A 7R1, Canada; Université de Sherbrooke, Department of family medicine and emergency medicine. 3001, 12e avenue Nord, Sherbrooke, QC. J1H 5N4, CanadaVitalité Health Network, 330 University Ave., Moncton, NB E1C 2Z3, CanadaVitalité Health Network, 330 University Ave., Moncton, NB E1C 2Z3, CanadaVitalité Health Network, 330 University Ave., Moncton, NB E1C 2Z3, CanadaCentre de Formation médicale du Nouveau-Brunswick, 50 de la Francophonie St, Moncton, NB E1A 7R1, Canada; Vitalité Health Network, 330 University Ave., Moncton, NB E1C 2Z3, Canada; Université de Moncton, Departement of chemistry and biochemistry, Moncton NB, E1C 2Z3; Department of Neurology, MAPR Clinic, Dr. Georges-L.-Dumont University Hospital Centre, 27 Providence Street, Moncton, NB, CanadaFetal alcohol spectrum disorder (FASD) encompasses a broad range of physical and neurological impairments resulting from prenatal alcohol exposure (PAE). While the neurological consequences of FASD are well documented, its potential association with vascular leukoencephalopathy (VL) remains poorly documented and incompletely understood. This case report presents a unique case of VL documented in a 20-year-old female diagnosed with FASD at 11 years of age, offering new insights into this underrecognized and potentially emerging association. The patient had several neurological and neurodevelopmental concerns starting in infancy, which prompted a number of brain Magnetic Resonance Imaging (MRI) scans throughout life. More recently, atypical neurological examination and comorbidities led to a referral to the neurology department to investigate a possible diagnosis of multiple sclerosis. Neurological evaluation, which included ordering a new MRI and reviewing previous scans, confirmed the presence of progressive white matter lesions suggestive of VL. Despite an extensive diagnostic workup, including genetic, metabolic, and autoimmune testing, no alternative etiology was identified. The patient’s clinical history, neurodevelopmental profile, and confirmed PAE raised the possibility of VL being associated with FASD as the most plausible explanation. This case highlights the potential vascular consequences of PAE, including disrupted angiogenesis, cerebral hypoperfusion, and increased blood-brain barrier permeability, mechanisms that mirror those seen in VL. As such, it emphasizes the importance of recognizing this possible association in a clinical setting. Early neuroimaging in FASD patients may facilitate timely detection of subclinical vascular pathology, guide treatment strategies, and help mitigate long-term neurological risks. Documenting such cases is crucial to expanding clinical awareness and supporting future research.http://www.sciencedirect.com/science/article/pii/S2666459325000769Vascular leukoencephalopathyFetal alcohol spectrum disorderFASDPrenatal alcohol exposureCerebral vascular abnormalitiesMagnetic Resonance Imaging |
| spellingShingle | Julie Gallien Nadia Bouhamdani Mahée Côté Dominique Bouhamdani M'Hamed Belkhodja Nicole Leblanc Ludivine Chamard-Witkowski Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood Brain Disorders Vascular leukoencephalopathy Fetal alcohol spectrum disorder FASD Prenatal alcohol exposure Cerebral vascular abnormalities Magnetic Resonance Imaging |
| title | Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood |
| title_full | Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood |
| title_fullStr | Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood |
| title_full_unstemmed | Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood |
| title_short | Vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder: An association not yet understood |
| title_sort | vascular leukoencephalopathy observed in a patient with fetal alcohol spectrum disorder an association not yet understood |
| topic | Vascular leukoencephalopathy Fetal alcohol spectrum disorder FASD Prenatal alcohol exposure Cerebral vascular abnormalities Magnetic Resonance Imaging |
| url | http://www.sciencedirect.com/science/article/pii/S2666459325000769 |
| work_keys_str_mv | AT juliegallien vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT nadiabouhamdani vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT maheecote vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT dominiquebouhamdani vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT mhamedbelkhodja vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT nicoleleblanc vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood AT ludivinechamardwitkowski vascularleukoencephalopathyobservedinapatientwithfetalalcoholspectrumdisorderanassociationnotyetunderstood |