Late-Onset Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy (CADASIL) Presenting With Abnormal MRI Findings and Migraine: A Case Report.

CADASIL is a hereditary condition affecting blood vessels in the brain. It usually appears in mid-adulthood with migraines, strokes, and cognitive decline. Late-onset cases are rare and can be hard to diagnose. This paper discusses a patient with late-onset CADASIL. They first experienced intermittent migraines along with unusual MRI results. The MRI showed significant abnormalities in white matter areas of the brain. These findings raised concerns about CADASIL. Genetic testing confirmed a mutation in the NOTCH3 gene, which is linked to the disease. This case emphasizes the need to consider CADASIL in older patients. It is especially important when they have unexplained MRI changes and migraines. Recognizing this condition early can help manage symptoms and improve patient outcomes. Awareness of CADASIL can lead to better diagnostic approaches for similar cases in the future. Clinical relevance: This research highlights the need for awareness of CADASIL in older migraine patients, which can improve diagnosis and treatment options.