Teaching NeuroImages: A prematurely aging patient presenting with severe leukoaraiosis and stroke

A 27-year-old woman presented with sudden onset left-sided numbness and double vision. In the last 10 years, she developed diabetes mellitus, cataract, osteoarthritis, osteoporosis, benign neoplasm of the skull, epilepsy, and nonscarring alopecia. Her parents were first-degree relatives and there