Background: Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is a rare neurodegenerative disease characterized by cerebral white matter abnormalities, which leads to progressive cognitive and motor dysfunction that usually presents in a middle-age. We present the pedigree, clinical, and imaging findings of familial cases with similar clinical features suggestive of progressive multiple sclerosis. Among our cases, two had died and the remaining one case is still alive, but with clinical symptoms getting worse, such as unable to verbally express themselves, unable to take care of themselves, worsening social relations and work abilities. Conclusion Because the clinical features and neuroimaging findings of inflammatory and neurodegenerative disorders of the nervous system often overlap, the definitive diagnostic test for ALSP (Adult-onset Leukoencephalopathy with Axonal Spheroids and Pigmented Glia) is genetic testing to identify CSF1R gene mutations. Although genetic testing is currently unavailable, it is advisable in clinical practice to apply diagnostic criteria and pay close attention to family history and characteristic neuroimaging findings when evaluating patients with progressive motor, cognitive, and language decline in order to suspect this condition.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.