Neuroradiology

, Volume 54, Issue 3, pp 255–260 | Cite as

Perfusion-weighted MR imaging in persistent hemiplegic migraine

  • Isabelle Mourand
  • Nicolas Menjot de Champfleur
  • Clarisse Carra-Dallière
  • Emmanuelle Le Bars
  • Agathe Roubertie
  • Alain Bonafé
  • Eric Thouvenot
Functional Neuroradiology

Abstract

Introduction

Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks.

Methods

Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated.

Results

Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI.

Conclusions

PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis.

Keywords

Hemiplegic migraine Familial hemiplegic migraine MRI Persistent aura 

Abbreviations

PWI

perfusion-weighted imaging

HM

Hemiplegic migraine

FHM

familial hemiplegic migraine

SHM

sporadic hemiplegic migraine

DWI

diffusion-weighted imaging

CBV

cerebral blood volume

FLAIR

fluid-attenuated inversion recovery

ICBF

Index of Cerebral Blood Flow

MTT

mean transit time

TTP

time to peak

TOF

3D time-of-flight

MRA

MR angiography

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Isabelle Mourand
    • 1
  • Nicolas Menjot de Champfleur
    • 1
  • Clarisse Carra-Dallière
    • 1
  • Emmanuelle Le Bars
    • 1
  • Agathe Roubertie
    • 2
  • Alain Bonafé
    • 1
  • Eric Thouvenot
    • 1
  1. 1.Service de NeuroradiologieHôpital Gui de ChauliacMontpellier Cedex 5France
  2. 2.Service de NeuropédiatrieHôpital Gui de ChauliacMontpellier Cedex 5France

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