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Clinical and MRI characteristics of acute migrainous infarction

M E Wolf1, K Szabo, M Griebe

  • 1Department of Neurology, UniversitätsMedizin Mannheim, University of Heidelberg, Mannheim, Germany. wolf@neuro.ma.uni-heidelberg.de

Neurology
|June 1, 2011
PubMed
Abstract

Insights

Migrainous infarction, a rare migraine complication, primarily affects younger women, often presenting with posterior circulation lesions. Delayed hospital presentation hinders diagnosis and treatment of these acute ischemic events.

Area of Science:

  • Neurology
  • Neuroimaging
  • Vascular Neurology

Background:

  • Migrainous infarction is a rare but serious complication of migraine, particularly migraine with aura.
  • Limited data exists on the specific lesion patterns in acute migrainous infarction.
  • Understanding these patterns is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the clinical and magnetic resonance imaging (MRI) characteristics of acute cerebral ischemia associated with migraine.
  • To identify patterns of brain lesions in patients experiencing migrainous infarction.

Main Methods:

  • Retrospective analysis of 17 patients with migraine-associated acute cerebral ischemia over 11 years.
  • Inclusion criteria: stroke patients with a history of migraine.
  • Methods included diffusion-weighted imaging (DWI) and assessment of clinical features and vascular risk factors.

Main Results:

  • Most patients (70.6%) had ischemic lesions in the posterior circulation.
  • Lesions were often small (64.7%) and multiple (41.2%) but in distinct arterial territories.
  • High prevalence of patent foramen ovale (64.7%) was noted; delayed hospital presentation (mean 33 hours) was common.

Conclusions:

  • Migrainous infarction predominantly affects younger women with a history of migraine with aura, often involving the posterior circulation.
  • Multiple, non-overlapping lesions suggest mechanisms beyond simple hemodynamic compromise.
  • Distinguishing migrainous infarction from prolonged migraine aura is challenging and linked to delayed patient admission.

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