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Updated: May 7, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Prevalence of white matter lesions and stroke in children with migraine
Soe Mar1, James E Kelly, Sara Isbell
1From the Departments of Pediatric and Developmental Neurology, and Radiology, Washington University School of Medicine, St. Louis, MO.
Objectives:
To determine the prevalence of white matter lesions (WMLs) and infarcts in children with migraine and whether pediatric migraine could be a risk factor for silent ischemic lesions or stroke.
Methods:
Prospectively collected data from 1,008 pediatric patients with headache were reviewed. The MRI data were collected and retrospectively reviewed.
Results:
Of the 926 patients diagnosed with migraine, 375 patients had MRIs and 115 had abnormalities, of which 39 had WMLs. Among them, 24 (6% of migraine) patients had incidental white matter findings without known neurovascular disease, risk factors, or etiologies for WMLs. The prevalence of WMLs is more common in migraine with aura (10%) than without aura (4%) (p = 0.038), but it is not statistically significant compared with controls (4%) (p = 0.119). Deep WMLs are more prevalent than periventricular lesions; these are detected mainly in the frontal and parietal lobes. No lesions appeared to be infarct-like lesions. There was no association between the total lesion load and chronicity or the frequency of migraine. WMLs are nonprogressive. Pediatric migraineurs with aura do not develop stroke, based on the available follow-up data.
Conclusion:
WMLs in pediatric patients with migraine and aura are no more prevalent than in controls. They appear to be benign and are not associated with stroke.
Insights
White matter lesions (WMLs) are not more common in children with migraine, even those with aura, compared to controls. These findings suggest WMLs in pediatric migraine are benign and not linked to stroke risk.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Migraine is a common neurological disorder in children.
- The presence and significance of white matter lesions (WMLs) in pediatric migraine patients require further investigation.
- Understanding potential links between pediatric migraine and cerebrovascular changes like silent ischemic lesions or stroke is crucial.
Purpose of the Study:
- To determine the prevalence of WMLs and infarcts in children experiencing migraine.
- To assess whether pediatric migraine serves as a risk factor for silent ischemic lesions or stroke.
Main Methods:
- Retrospective review of prospectively collected data from 1,008 pediatric patients with headache.
- Analysis of MRI data from 926 patients diagnosed with migraine, focusing on 375 who underwent MRI scans.
Main Results:
- Of 375 migraine patients with MRIs, 115 had abnormalities, including 39 with WMLs. Six percent of migraine patients had incidental WMLs without known neurovascular disease or risk factors.
- WMLs were more prevalent in migraine with aura (10%) than without aura (4%), though not statistically significant compared to controls (4%).
- Deep WMLs, primarily in frontal and parietal lobes, were more common than periventricular lesions; no infarct-like lesions were observed. WMLs were nonprogressive and not associated with migraine chronicity or frequency.
Conclusions:
- WMLs in pediatric migraine patients, including those with aura, are not more prevalent than in control groups.
- The observed WMLs appear benign and are not associated with an increased risk of stroke in this pediatric population.
