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Updated: May 19, 2026
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Reversible paresis of the left hand related to a migraine without aura attack
Ferdinando Maggioni1, Federica Viaro, Renzo Manara
1Department of Neurosciences, Headache Centre, University of Padua, Padua, Italy. ferdinando.maggioni@unipd.it
Introduction:
The comorbidity between migraine and stroke continues to be a debated topic. Prior cases of reversible neuroradiologic lesions have been described in migrainous patients and in particular for those suffering from migraine with aura or complicated migraine attacks.
Case Report:
We describe a patient that presented with a migraine without aura (MO) attack followed by paresis of the left hand that resolved completely within 4 days. An early brain magnetic resonance image (MRI) showed congruent cytotoxic-like alteration, whereas the lesion was no longer detectable on a standard 8-day MRI follow-up. A focused high-resolution MRI disclosed a very small cortical lesion, whereas a functional MRI demonstrated normal activation of the previously affected cortex at 8-month follow-up.
Conclusions:
This MO patient presented with an ischemic-like lesion associated with migraine that reversed completely on MRI examination suggesting that migrainous infarction can occur in MO. Focused high-resolution sequences at follow-up might disclose subtle cortical lesions that could be more frequent than thought, coexisting with the well-known white matter hyperintensities not associated with neurological signs.
Insights
Migraine without aura (MO) can be associated with reversible ischemic-like brain lesions. Advanced MRI techniques may reveal subtle, transient cortical changes in MO patients, suggesting migrainous infarction is possible.
Area of Science:
- Neurology
- Neuroimaging
Background:
- The relationship between migraine and stroke is complex and debated.
- Reversible brain lesions have been noted in migraine patients, particularly those with aura or complicated attacks.
Observation:
- A patient experienced a migraine without aura (MO) followed by temporary left-hand weakness.
- Initial MRI showed a cytotoxic-like lesion, which resolved by day 8.
- High-resolution MRI revealed a small cortical lesion, and functional MRI showed normal cortical activation after 8 months.
Findings:
- The patient's MO attack was linked to a transient ischemic-like lesion.
- The lesion completely reversed on follow-up MRI, supporting the concept of migrainous infarction in MO.
Implications:
- Migrainous infarction may occur in migraine without aura (MO).
- Subtle cortical lesions associated with migraine might be more common than previously thought.
- Advanced neuroimaging techniques are crucial for detecting transient migrainous lesions.
