Migraine with Aura: A CADASIL Case

Abstract

This patient was a 42-year-old man who had suffered from headache attacks since he was 24 years old. Most of the attacks started with a gray dot in the corner of the right visual field, increasing to a right hemianopsia within 20 min, which quickly disappeared. There never were left-sided visual disturbances. During some of the attacks there were right-sided paresthesias in the arm and face; once his wife noticed slurred speech. Left-sided throbbing headache normally occurred shortly after the disappearance of these symptoms, with some nausea and photophobia and lasting for 1 or 2 days. One or two tablets of paracetamol would sufficiently decrease the intensity of the pain and enable continuance of daily activities. Frequency of the attacks varied from only one per year to once per month. A diagnosis of migraine with aura was made, with no need for further analysis or adjustment of treatment.