Editing CADASIL (section)

==Signs and symptoms==
CADASIL may start with attacks of [[migraine]] with [[Aura (symptom)|aura]] or subcortical transient ischemic attacks or strokes, or mood disorders between 35 and 55 years of age. The disease progresses to [[subcortical dementia]] associated with [[pseudobulbar palsy]] and [[urinary incontinence]].{{citation needed|date=September 2019}}

[[Ischemic stroke]]s are the most frequent presentation of CADASIL, with approximately 85% of symptomatic individuals developing [[transient ischemic attack]]s or stroke(s). The mean age of onset of ischemic episodes is approximately 46 years (range 30–70). A classic [[lacunar syndrome]] occurs in at least two-thirds of affected patients while hemispheric strokes are much less common. It is worthy of note that ischemic strokes typically occur in the absence of traditional cardiovascular risk factors. Recurrent silent strokes, with or without clinical strokes, often lead to cognitive decline and overt subcortical dementia. A case of CADASIL presenting as schizophreniform organic psychosis has been reported.<ref>{{cite journal | doi = 10.1016/j.genhosppsych.2015.02.006 | pmid=25824603 | title=CADASIL presenting as schizophreniform organic psychosis | journal=General Hospital Psychiatry| volume=37 | issue=3 | pages=273.e11–273.e13 | year=2015 | last1=Ho | first1=Cyrus S.H. | last2=Mondry | first2=Adrian }}</ref>