An MR study of tissue damage in the cervical cord of patients with migraine

Hyperintense abnormalities on T2-weighted magnetic resonance (MR) scans of the brain from patients with migraine are a relatively frequent finding and may represent a diagnostic challenge. We studied the cervical cord of patients with migraine using T2-weighted and magnetization transfer (MT) scans to assess whether the study of macro- and microscopic tissue damage in the cervical cord of these patients may have some diagnostic utility. T2-weighted and MT scans of the cervical cord and dual-echo scans of the brain were acquired from 16 patients with migraine and 17 sex- and age-matched healthy volunteers. Cervical cord MT ratio (MTR) histograms were obtained from all subjects and the relative peak height, the peak position, and the average MTR measured. Five migraine patients (31%) had hyperintense lesions in the brain. Neither healthy controls nor patients with migraine had any abnormalities on cervical cord MR scans. There was no difference for any of the cord MTR histogram-derived metrics between patients with migraine and healthy controls. No MTR histogram-derived measures from migraine patients were 2 standard deviations below the mean values from controls. Patients with migraine do not have MR or MT abnormalities in the cervical cord. MR scanning of the cervical cord in patients with migraine and hyperintense brain lesions of unknown etiology may be a useful investigation to facilitate the diagnostic workout.