Status migrainosus: an unusual presentation of a brain abscess

Area of Science:

• Neurology
• Infectious Diseases
• Neuroimaging

Background:

• Status migrainosus is a debilitating migraine complication.
• Brain abscesses are typically associated with known infectious processes.
• Migraine with aura is a common neurological condition.

Observation:

• A patient with a history of migraine with aura presented with prolonged, severe migraine attacks.
• No preceding or concurrent signs of infection were noted.
• The patient's symptoms were initially attributed solely to status migrainosus.

Findings:

• Diagnostic imaging revealed a brain abscess as the underlying cause of the prolonged migraine symptoms.
• Status migrainosus was the sole presenting manifestation of the brain abscess.
• The patient had no prior history suggestive of pyogenic infection.

Implications:

• This case underscores the importance of considering uncommon diagnoses in refractory status migrainosus.
• Brain abscess should be included in the differential diagnosis for patients presenting with atypical or prolonged migraine.
• Early neuroimaging may be crucial for identifying rare but serious underlying causes of severe headache syndromes.