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#Migraine with aura serial
Serial MRI in a case of familial hemiplegic migraine. Palm-Meinders IH, Koppen H, Terwindt GM et-al. Migraine and white matter hyperintensities: the ARIC MRI study. Susceptibility-weighted imaging in migraine with aura. Infarcts in the posterior circulation territory in migraine. Brain gray matter changes in migraine patients with T2-visible lesions: a 3-T MRI study. chronic small vessel deep white matter ischemic change.These are distinguished predominantly on history, although recent 3 T work 1 suggest that there is increased T2 signal in the cortex overlying white matter abnormalities as well as in the brainstem 1: MRI may demonstrate T2 hyperintensities in the white matter of the centrum semiovale, not dissimilar to small vessel deep white matter ischemic change. Changes in cerebral perfusion have also been described 3. In hemiplegic migraines, venous dilatation can be seen on SWI MIP images contralateral to the hemiparesis, although this is not typical 3. In the vast majority of cases, MRI is normal. Radiographic features CTĬT is usually unhelpful, except in cases of extensive cortical infarction. This classic pattern is relatively uncommon accounting for ~10% of the migrainous patients and is unlikely to be an accurate reflection of the pathophysiology involved. The classical explanation describes a headache (due to vasodilation) preceded by neurological symptoms, most classically visual (due to vasoconstriction). They typically comprise of one or more of the following: changes in mood, blurred vision, photophobia, phonophobia, fatigue, poor concentration and neck stiffness 7. These may occur hours or even a couple of days before and after the migraine respectively. In addition to auras and the headache, two other phases may be present: prodrome and postdrome. They are followed by headache within an hour of onset 7.
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The neurological deficits can be very varied and last 5 to 60 minutes and eventually fully resolve. Migraines with aura are usually preceded by focal neurological deficits, although in some individuals the aura can occur concurrently with the headache 7. The headache is often associated with photophobia, phonophobia and nausea and is worsened by physical activity 7. Migraines without aura usually consist of a headache that lasts 4 to 72 hours that is typically unilateral, moderate to severe and has a pulsating quality. Migraines are broadly divided into those with and those without auras 7.