Related Experiment Video
Updated: Jul 19, 2025
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Diagnosis of Migrainous Infarction: A Case Report and Analysis of Previously Published Cases
Elena R Lebedeva1,2, Natalia M Gurary3, Jes Olesen4
1Department of Neurology, The Ural State Medical University, 620028 Yekaterinburg, Russia.
Abstract:
Migrainous infarction (MI) is a rare disorder. The precise diagnostic criteria for this diagnosis have been available in the International Classification of Headache Disorders (ICHD) since 1988, but many cases do not fulfil these criteria. This paper describes a good example of MI and analyzes previously published case reports. We report a very special case of MI in an 18-year-old woman who had a recurrent episode of migraine with a similar aura with numbness of the right arm and speech disturbances which had an unusually long duration (>120 min). On admission to the headache centre "Europe-Asia", she complained of slowness of speech and problems with choice of words. An MRI showed acute lacunar infarcts in the left parietal subcortical area. Ischemic infarcts were localized in a relevant area on the left side and the aura symptoms were right-sided. The patient, therefore, fulfilled the ICHD-3 diagnostic criteria for "Migrainous infarction". An analysis of 35 previously published articles with case reports about MI showed that 22 did not meet the diagnostic criteria of the ICHD for migrainous infarction. Using all this, we developed diagnostic recommendations for migrainous infarction which can help to improve the quality of diagnosis when used together with the diagnostic criteria of the ICHD for migrainous infarction.
Insights
Migrainous infarction (MI) is rare, and many cases don't meet diagnostic criteria. This study presents a case and proposes recommendations to improve migrainous infarction diagnosis.
Area of Science:
- Neurology
- Neuroscience
- Vascular Neurology
Background:
- Migrainous infarction (MI) is a rare neurological disorder.
- Diagnostic criteria exist in the International Classification of Headache Disorders (ICHD) but are often unmet.
- Accurate diagnosis of MI is crucial for appropriate patient management.
Observation:
- A unique case of MI in an 18-year-old female with prolonged migraine aura symptoms (>120 min) including right arm numbness and speech disturbances.
- Neuroimaging (MRI) revealed acute lacunar infarcts in the left parietal subcortical area, correlating with the right-sided aura symptoms.
- The patient's presentation met the ICHD-3 diagnostic criteria for migrainous infarction.
Findings:
- Analysis of 35 published MI case reports revealed that 22 did not meet ICHD diagnostic criteria.
- A significant discrepancy exists between reported cases and established diagnostic standards for MI.
- The study highlights challenges in diagnosing migrainous infarction accurately.
Implications:
- The findings underscore the need for refined diagnostic approaches to migrainous infarction.
- Developed diagnostic recommendations aim to enhance diagnostic accuracy when used with ICHD criteria.
- Improved diagnostic quality for MI can lead to better patient outcomes and understanding of this rare condition.
