Stroke, migraine and intracranial aneurysm: a case report

Area of Science:

• Neurology
• Neuroscience
• Ophthalmology

Background:

• Recurrent ophthalmic migraine attacks can be debilitating.
• Migrainous infarcts are a rare but serious complication of migraine.

Observation:

• A patient experienced recurrent ophthalmic migraine attacks since childhood.
• Following an attack, the patient developed permanent quadrantanopsia due to a right occipital infarct.
• Subsequent migraine attacks exhibited a progressive visual phenomenon pattern.

Findings:

• The initial angiography showed a posterior cerebral artery (PCA) occlusion.
• A follow-up angiography two years later revealed a PCA aneurysm.
• The findings suggest a primary neuronal phenomenon contributing to the visual disturbances.

Implications:

• This case highlights the importance of comprehensive and repeated vascular evaluations in patients diagnosed with migrainous infarcts.
• Delayed diagnosis of underlying vascular abnormalities, such as aneurysms, can occur.
• Thorough investigation is essential to differentiate between migraine complications and other neurological events.