Fatal migraine

Area of Science:

• Neurology
• Pathology

Background:

• Migraine is a common neurological disorder.
• Cerebral infarction, or stroke, is a leading cause of death and disability.

Observation:

• A 58-year-old woman with a history of migraine experienced stroke-like symptoms.
• Clinical presentation included hemiplegia, gaze palsy, and severe headache.
• Brain imaging revealed a large right parietotemporal infarct.

Findings:

• Autopsy confirmed a large infarct in the territory of the right middle cerebral artery.
• Cerebral infarction preceded the formation of a thrombus in the right middle cerebral artery.
• Histological findings supported arterial spasm as the primary cause of infarction, with thrombosis as a secondary event.

Implications:

• This case underscores the potential for migraine to trigger severe cerebrovascular events.
• Arterial spasm should be considered in the differential diagnosis of stroke in patients with migraine.
• Further research is needed to elucidate the mechanisms linking migraine and arterial spasm in stroke.