Migraine-like headache as the presenting symptom of basilar artery occlusion

Heckmann, Josef G.; Läng, Christoph; Weber, M.; Tomandl, Bernd; Neundörfer, B.

doi:10.1007/s101940300026

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Saquegna et al 3 8 reported a case series in which 'migrainous stroke' was defined as a 'sudden-onset focal neurological deficit not fully reversible within seven days and/or associated with neuroimaging confirmation of cerebral infarction -occurring during a common migraine attack or following the It is unclear if the simultaneous occurrence of MWA or MwoA and stroke represents a migrainous infarction since migraine headaches may occur during acute stroke 11 and MWA may be the presenting manifestation of a diverse group of disorders including: occipital 51 and brainstem 52 arteriovenous malformations; occipital lobe tumors; 5 3 s u b a r a c h n o i d hemorrhage; 54 occipital lobe epilepsy; 55 radiation-induced 56 and post-partum 57 cerebral vasculopathy; moyamoya disease; 58 and basilar artery dissection. 59 Shuaib 60 cautioned against the uncritical use of the term migraine-stroke in a case series in which five subjects identified as suffering from migraine-stroke were found to have other significant stroke etiologies, including arterial dissection, endocarditis, and atherosclerosis. A recent case-control study by Tzourio et al 61 observed that MwoAis more common in subjects with cervical artery dissection compared to hospitalized controls, further supporting the hypothesis that an underlying arterial wall disease may be a predisposing condition for migraine.…”

Section: Mwa and Migraine-strokementioning

confidence: 99%

Progress in Clinical Neurosciences: Migraine-Stroke: A Causal Relationship, but Which Direction?

Kern

2004

Can. j. neurol. sci.

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The association between migraine attacks and permanent neurological deficits has been recognized since the original description of persistent visual deficits by Féré in 1861 1 and Galezowski in 1881. 2 Féré described 10 cases, of which four were left with permanent deficits that included hemianopia (3) and aphasia (1). The term 'complicated migraine'was coined by Charcot in 1890. 3 Subsequently in 1915, Hunt 4 expanded the range of neurological deficits associated with a migraine attack to include permanent paralysis.More recently a wide range of descriptive terminology has emerged to define the complex relationship between migraine and stroke. This includes: 'active migraine and stroke ', 5 'migrainous infarction', 6 'migraine-induced stroke' a n d ABSTRACT: A significant association between migraine and ischemic stroke has been demonstrated in population and case-control studies. The risk of ischemic stroke appears to be higher in migraine with aura (MWA) than migraine without aura (MwoA). Migraine-stroke comprises a number of distinct entities, including migrainous infarction, in which ischemic stroke occurs during an attack of MWA and migraine-related stroke, in which the causal link is less clear. Migrainous infarction accounts for only one-third of migraine-stroke, strokes may occur during attacks of MwoA, and a number of cerebrovascular disorders may present as MWA or MwoA. Migraine may occur as a consequence of conditions that are known to cause stroke; therefore it remains to be determined whether migraine predisposes to stroke in the absence of any known disease associations, if it is an epiphenomenon of an underlying stroke diathesis, or if it requires the presence of another stroke risk factor to produce cerebral ischemia. Furthermore, it is unclear if ischemia results in migraine more often than migraine results in ischemia. Careful clinical studies that evaluate this bidirectional relationship are needed to determine why migraine patients are subject to a higher risk of ischemic stroke.RÉSUMÉ: Migraine -accident vasculaire cérébral: une relation causale, mais dans quelle direction? Des études de population et des études cas-témoin ont montré une association significative entre la migraine et l'accident vasculaire cérébral ischémique (AVCI). Le risque de faire un AVCI semble plus élevé dans la migraine avec aura (MAA) que dans la migraine sans aura (MSA). La migraine -AVC comprend plusieurs entités distinctes dont l'infarctus migraineux dans lequel l'AVCI survient pendant une crise de MAAet la migraine reliée à l'AVC dont le lien causal est moins clair. L'infarctus migraineux explique seulement le tiers des cas de migraine -AVC. Un AVC peut survenir pendant une crise de MAA et certains troubles vasculaires cérébraux peuvent avoir un mode de présentation semblable à celui de la MAA ou de la MSA. La migraine peut survenir comme conséquence de pathologies reconnues comme causant l'AVC. Il reste donc à déterminer si la migraine prédispose à l'AVC en l'absence d'une association connue avec une autre ma...

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Section: Mwa and Migraine-strokementioning

confidence: 99%

Progress in Clinical Neurosciences: Migraine-Stroke: A Causal Relationship, but Which Direction?

Kern

2004

Can. j. neurol. sci.

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Basilar artery occlusion in migraine-like headache: a possible triggering effect of sumatriptan

2011

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Headache is a common symptom at the onset of acute ischemic cerebrovascular disease. Simultaneous development of migraine-like headache and stroke in the same patient makes it difficult to differentiate between migraine-induced stroke and migraine-like headache attributed to ischemic stroke. We report a case of a 34-year-old woman with no previous migraine history who presented with migraine-like headache, thought to be a first attack of migraine, and who developed brainstem infarction shortly after triptan administration. Magnetic resonance imaging revealed an acute pontine infarction, and CT angiography revealed occlusion of the basilar artery. A detailed etiological evaluation revealed no risk factor for ischemic stroke. We believe that the migraine-like headache was the first symptom of cerebral ischemia and that sumatriptan accelerated the development of the infarction. This case report emphasizes the importance of accurate diagnosis of migraine before using triptans. Secondary causes of migraine-like headache should be excluded, especially in patients with migraine-like headache for the first time.

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Migraine-like headache as the presenting symptom of basilar artery occlusion

Cited by 2 publications

References 14 publications

Progress in Clinical Neurosciences: Migraine-Stroke: A Causal Relationship, but Which Direction?

Progress in Clinical Neurosciences: Migraine-Stroke: A Causal Relationship, but Which Direction?

Basilar artery occlusion in migraine-like headache: a possible triggering effect of sumatriptan

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