TY - JOUR
T1 - Pediatric hemiplegic migraine
T2 - Role of multiple MRI techniques in evaluation of reversible hypoperfusion
AU - Bosemani, Thangamadhan
AU - Burton, Vera J.
AU - Felling, Ryan J.
AU - Leigh, Richard
AU - Oakley, Christopher
AU - Poretti, Andrea
AU - Huisman, Thierry Agm
PY - 2014/4
Y1 - 2014/4
N2 - Background: Hemiplegic migraine (HM) is a rare type of migraine with aura that involves motor weakness. Data on conventional and advanced neuroimaging findings during prolonged attacks of HM are limited, particularly in children. Case: A 13-year-old-female with a history of migraine had a typical attack of HM characterized by right-sided hemiplegia, deterioration of vigilance and paraphasia. MRI performed 3 hours after hemiplegia onset revealed normal diffusion tensor imaging (DTI) sequences, but perfusion weighted imaging (PWI) showed a large area of hypoperfusion within the left cerebral hemisphere and susceptibility weighted imaging (SWI) demonstrated a matching area with prominent, hypointense draining sulcal veins. Magnetic resonance angiography (MRA) revealed subtle narrowing of the left middle cerebral artery. The neuroimaging abnormalities completely resolved 24 hours after the attack onset. Conclusion: Multiple conventional and advanced MRI techniques including SWI play a key role in an HM attack to (1) exclude acute arterial ischemic stroke and (2) further understand the pathophysiology of HM.
AB - Background: Hemiplegic migraine (HM) is a rare type of migraine with aura that involves motor weakness. Data on conventional and advanced neuroimaging findings during prolonged attacks of HM are limited, particularly in children. Case: A 13-year-old-female with a history of migraine had a typical attack of HM characterized by right-sided hemiplegia, deterioration of vigilance and paraphasia. MRI performed 3 hours after hemiplegia onset revealed normal diffusion tensor imaging (DTI) sequences, but perfusion weighted imaging (PWI) showed a large area of hypoperfusion within the left cerebral hemisphere and susceptibility weighted imaging (SWI) demonstrated a matching area with prominent, hypointense draining sulcal veins. Magnetic resonance angiography (MRA) revealed subtle narrowing of the left middle cerebral artery. The neuroimaging abnormalities completely resolved 24 hours after the attack onset. Conclusion: Multiple conventional and advanced MRI techniques including SWI play a key role in an HM attack to (1) exclude acute arterial ischemic stroke and (2) further understand the pathophysiology of HM.
KW - Susceptibility weighted imaging
KW - children
KW - hemiplegic migraine
KW - neuroimaging
KW - perfusion-weighted imaging
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U2 - 10.1177/0333102413509432
DO - 10.1177/0333102413509432
M3 - Article
C2 - 24142848
AN - SCOPUS:84896486008
SN - 0333-1024
VL - 34
SP - 311
EP - 315
JO - Cephalalgia
JF - Cephalalgia
IS - 4
ER -