Question category: Neurology
A 45 year old male has attended the GP with his wife who has noticed a change in his personality and cognitive impairment over the last 6 months. He has previous history of a stroke and TIAs. He has a family history of stroke at young age. His son has suffers from migraines and has presented with what seemed like TIAs. On examination he has a right hemiparesis, is hyperreflexic and has upgoing plantars. He has an MMSE of 22/30. What is the likely underlying diagnosis?