Hemiplegic migraine aura begins with cerebral hypoperfusion: imaging in the acute phase

TY - JOUR

T1 - Hemiplegic migraine aura begins with cerebral hypoperfusion

T2 - imaging in the acute phase

AU - Hansen, Jakob M

AU - Schytz, Henrik W

AU - Larsen, Vibeke A

AU - Iversen, Helle Klingenberg

AU - Ashina, Messoud

N1 - © 2011 American Headache Society.

PY - 2011/9

Y1 - 2011/9

N2 - Imaging studies of spontaneous migraine aura have proved challenging because of the episodic and unpredictable nature of migraine attacks. Two patients with signs of acute ischemic stroke were evaluated for thrombolysis and turned out to suffer from familial hemiplegic migraine. It was possible to record the early phase of the hemiplegic aura with computed tomography with perfusion sequences and magnetic resonance imaging. We found cerebral hypoperfusion in the relevant cortical areas within the first hour after onset of aura symptoms. This report supports the concept that migraine aura across the migraine spectrum is caused by similar mechanisms. In a setting with efficient cooperation between headache and stroke neurologists, thrombolysis centers provide the set-up and opportunity to record aura symptoms at an early phase. Furthermore, in the time of ready access to acute systemic thrombolysis treatment, these cases underscore the importance of an accurate headache history, especially in younger patients.

AB - Imaging studies of spontaneous migraine aura have proved challenging because of the episodic and unpredictable nature of migraine attacks. Two patients with signs of acute ischemic stroke were evaluated for thrombolysis and turned out to suffer from familial hemiplegic migraine. It was possible to record the early phase of the hemiplegic aura with computed tomography with perfusion sequences and magnetic resonance imaging. We found cerebral hypoperfusion in the relevant cortical areas within the first hour after onset of aura symptoms. This report supports the concept that migraine aura across the migraine spectrum is caused by similar mechanisms. In a setting with efficient cooperation between headache and stroke neurologists, thrombolysis centers provide the set-up and opportunity to record aura symptoms at an early phase. Furthermore, in the time of ready access to acute systemic thrombolysis treatment, these cases underscore the importance of an accurate headache history, especially in younger patients.

KW - Acute Disease

KW - Adult

KW - Brain Ischemia

KW - Cerebrovascular Circulation

KW - Diffusion Tensor Imaging

KW - Disease Progression

KW - Hemiplegia

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Migraine with Aura

U2 - 10.1111/j.1526-4610.2011.01963.x

DO - 10.1111/j.1526-4610.2011.01963.x

M3 - Journal article

C2 - 21797860

SN - 1526-4610

VL - 51

SP - 1289

EP - 1296

JO - Headache

JF - Headache

IS - 8

ER -