IntroductionAdult-onset autosomal dominant leukodystrophy (ADLD) is an ultra-rare inherited white matter disorder caused by variants in the LMNB1 gene. Here, we report a case of ADLD and characterize its typical magnetic resonance imaging (MRI) features, with the aim of facilitating its clinical recognition and differential diagnosis.Case descriptionThe patient was a 55-year-old male who had experienced incomplete voiding, dysuria, and constipation for 10 years. One year prior to presentation, h