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Updated: Jul 26, 2025
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Investigations of the subarachnoid space as a potential link between aura and headache in migraine: A case-control
Andreas Vinther Thomsen1, Oula Puonti2, David Gaist3
1Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
Background:
The connection between migraine aura and headache is poorly understood. Some patients experience migraine aura without headache, and patients with migraine aura with headache commonly experience milder headaches with age. The distance between the cerebral cortex and the overlying dura mater has been hypothesized to influence development of headache following aura. We tested this hypothesis by comparing approximated distances between visual cortical areas and overlying dura mater between female patients with migraine aura without headache and female patients with migraine aura with headache.
Methods:
Twelve cases with migraine aura without headache and 45 age-matched controls with migraine aura with headache underwent 3.0 T MRI. We calculated average distances between the occipital lobes, between the calcarine sulci, and between the skull and visual areas V1, V2 and V3a. We also measured volumes of corticospinal fluid between the occipital lobes, between the calcarine sulci, and overlying visual areas V2 and V3a. We investigated the relationship between headache status, distances and corticospinal fluid volumes using conditional logistic regression.
Results:
Distances between the occipital lobes, calcarine sulci and between the skull and V1, V2 and V3a did not differ between patients with migraine aura with headache and patients with migraine aura without headache. We found no differences in corticospinal fluid volumes between groups.
Conclusion:
We found no indication for a connection between visual migraine aura and headache based on cortico-cortical, cortex-to-skull distances, or corticospinal fluid volumes overlying visual cortical areas. Longitudinal studies with imaging sequences optimized for measuring the cortico-dural distance and a larger sample of patients are needed to further investigate the hypothesis.
Insights
This study found no link between visual migraine aura and headache based on brain structure measurements. Cortico-cortical and cortex-to-skull distances, as well as cerebrospinal fluid volumes, did not differ between groups.
Area of Science:
- Neurology
- Neuroimaging
- Migraine Pathophysiology
Background:
- The relationship between migraine aura and headache remains unclear.
- Some individuals experience migraine aura without a subsequent headache.
- Headache severity in migraine with aura may decrease with age.
Purpose of the Study:
- To investigate the hypothesis that the distance between the cerebral cortex and dura mater influences headache development after migraine aura.
- To compare distances between visual cortical areas and the dura mater in patients with and without headache during migraine aura.
Main Methods:
- Magnetic resonance imaging (MRI) was used to compare 12 female patients with migraine aura without headache and 45 age-matched controls with migraine aura with headache.
- Calculated distances between occipital lobes, calcarine sulci, and skull to visual areas (V1, V2, V3a).
- Measured cerebrospinal fluid volumes and analyzed relationships using conditional logistic regression.
Main Results:
- No significant differences were found in distances between occipital lobes, calcarine sulci, or skull to visual areas V1, V2, and V3a between the two groups.
- Cerebrospinal fluid volumes overlying visual cortical areas also showed no differences between patients with and without headache.
Conclusions:
- The study found no evidence supporting a connection between visual migraine aura and headache based on the measured cortico-cortical, cortex-to-skull distances, or cerebrospinal fluid volumes.
- Further longitudinal research with optimized imaging and larger patient cohorts is recommended to explore the cortico-dural distance hypothesis.
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