The age of onset, which is when symptoms first become apparent, can be very different in one person with CADASIL when compared to another person. This is true for people in the same family. Generally, episodes of lack of blood flow to the brain (ischemic episodes) begin around 45-50 years of age. Migraines can appear as early as the 30s. Although the onset of CADASIL is usually in adulthood, there are very rare instances where children have developed symptoms.