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Updated: Dec 13, 2025
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Findings in susceptibility weighted imaging in pediatric patients with migraine with aura
Frauke Kellner-Weldon1, Vera Franziska Lehmann1, Philipe Sebastian Breiding2
1Support Center for Advanced Neuroimaging, University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Background:
Migraine with aura (MwA) in pediatric patients is clinically frequent. Clinically complex symptoms need to be differentiated to exclude mimicking conditions.
Purpose:
We hypothesize that MwA in children induces abnormalities readily visible in perfusion time to peak (TTP) maps as well as non-enhanced susceptibility weighted magnetic resonance imaging (SWI).
Materials And Methods:
Between 2010 and 2018, we retrospectively evaluated symptoms and imaging of consecutive pediatric patients <18 years with MwA. We visually scored abnormalities on SWI and TTP maps in 12 regions of interest on both hemispheres on three axial slices, as normal, slightly, distinctly or severely abnormal.
Results:
99 patients (69.7% female), mean age 14.07 y (±2.8) were included. Focally increased deoxygenation (FID) in SWI was present in 61.6%. FID on SWI was dominant for the left hemisphere (60.7% vs. 31.1%, (p < .001)), and in 8.2% symmetric. Side of aura symptoms and contralateral hemispheric imaging alterations in patients with FID correlated significantly (p = .002.). 61 of 99 patients had perfusion MR and 59% of these patients showed focal increase of TTP. Age correlated significantly with FID in SWI (r = -.248, p = .013) and increase of TTP in perfusion (r = -.252, p = .05). Focal abnormalities correlated significantly between SWI and TTP maps. Brain regions most often abnormal were the temporal superior, occipital and fronto-parietal regions.
Conclusions:
This study provides confidence in recognizing FID, and linking FID in SWI to acute MwA in pediatric patients. FID phenomenon had a left hemispheric significant dominance, and can be found bilaterally.
Insights
Pediatric migraine with aura (MwA) shows focal increased deoxygenation (FID) on susceptibility-weighted imaging (SWI) and perfusion imaging. These abnormalities, particularly FID, are often left-hemisphere dominant and correlate with aura symptoms.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuroimaging
Background:
- Migraine with aura (MwA) is common in children.
- Differentiating MwA from other conditions with similar symptoms is crucial.
Purpose of the Study:
- To investigate if MwA in children causes visible abnormalities on perfusion time to peak (TTP) and non-enhanced susceptibility-weighted magnetic resonance imaging (SWI).
- To establish the utility of SWI and TTP maps in diagnosing pediatric MwA.
Main Methods:
- Retrospective analysis of 99 pediatric patients (<18 years) with MwA between 2010 and 2018.
- Visual scoring of SWI and TTP maps in 12 brain regions across three axial slices for abnormality.
- Correlation of imaging findings with clinical symptoms and patient age.
Main Results:
- Focally increased deoxygenation (FID) on SWI was observed in 61.6% of patients, predominantly in the left hemisphere.
- 61% of patients with perfusion MRI showed a focal increase in TTP.
- Abnormalities on SWI and TTP maps correlated significantly, with temporal superior, occipital, and fronto-parietal regions most affected.
Conclusions:
- SWI and TTP imaging can help identify acute MwA in pediatric patients.
- FID on SWI demonstrates a significant left-hemispheric dominance in pediatric MwA.
- Imaging findings correlate with clinical presentation and can be bilateral.
