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Updated: Aug 18, 2026
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Perfusion weighted imaging during migraine: spontaneous visual aura and headache
M Sanchez del Rio1, D Bakker, O Wu
1Department of Neurology, Magnetic Resonance Center, Boston, MA, USA. sanchezm@helix.mgh.harvard.edu
Abstract:
Using perfusion weighted imaging, we studied 28 spontaneous migraine episodes; 7 during visual aura (n = 6), 7 during the headache phase following visual aura (n = 3), and 14 cases of migraine without aura (n = 13). The data were analyzed using a region-of-interest-based approach. During aura, relative cerebral blood flow (rCBF) was significantly decreased (27% +/- 0.07) in occipital cortex contralateral to the affected hemifield. rCBV was decreased (15% +/- 0.12) and mean transit time increased (32% +/- 0.3), persisting up to 2.5 h into the headache phase. Other brain regions did not show significant perfusion changes. During migraine without aura, no significant hemodynamic changes were observed. In one patient who experienced both migraine with and without aura, perfusion deficits were observed only during migraine with aura. These findings suggest that decremental blood flow changes in occipital lobe are most characteristic of migraine with aura.
Insights
Migraine with aura involves decreased blood flow in the occipital lobe, unlike migraine without aura. These cerebral blood flow changes during visual aura persist into the headache phase.
Area of Science:
- Neuroimaging
- Neurology
- Medical Imaging
Background:
- Migraine is a common neurological disorder.
- The pathophysiology of migraine with aura is not fully understood.
- Cerebral blood flow changes during migraine episodes require further investigation.
Purpose of the Study:
- To investigate cerebral blood flow changes during migraine with and without aura using perfusion weighted imaging.
- To determine if specific hemodynamic alterations characterize migraine with aura.
Main Methods:
- Studied 28 spontaneous migraine episodes using perfusion weighted imaging.
- Analyzed data using a region-of-interest-based approach.
- Measured relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and mean transit time (MTT).
Main Results:
- During visual aura, significant decreases in rCBF (27%) were observed in the occipital cortex.
- Reduced rCBV (15%) and increased MTT (32%) persisted into the headache phase.
- No significant hemodynamic changes were detected during migraine without aura.
Conclusions:
- Decremental blood flow changes in the occipital lobe are characteristic of migraine with aura.
- These perfusion deficits are specific to the aura phase and can extend into the headache phase.
- Migraine without aura does not exhibit these specific hemodynamic alterations.
