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Abstract Details

Perfusion Imaging in Acute Hemiplegic Migraine
Headache
P5 - Poster Session 5 (11:45 AM-12:45 PM)
15-003
To highlight normal angiographic with abnormal perfusion imaging in a patient with hemiplegic migraine.
Acute neurologic symptoms can present prior, during and after the onset of the headache. It can also outlast the headache and persist for many days. These symptoms can also be found in acute stroke or a hemiplegic migraine creating a diagnostic dilemma.
Not applicable
We present the case of  47-year-old female with a history of migraines who presented with acute unilateral headache and progressive right-sided hemiparesis. Head computed tomography (CT) with angiography was unremarkable, and perfusion imaging showed regional hypoperfusion of the anterior left frontal lobe. Conservative treatment of her migraine led to resolution of her pain and weakness. A follow up CT scan of the head obtained twenty hours after symptoms onset did not show evidence of an acute intracranial abnormality.
Hemiplegic migraine is an uncommon mimic of acute stroke. Rare case reports indicate brief hypoperfusion changes in the affected hemisphere during the aura. Normal angiographic with abnormal perfusion imaging may be suggestive of this mimic in the appropriate clinical context.
Authors/Disclosures
Kyle R. Marden, MD (Northwestern Medicine)
PRESENTER 		Dr. Marden has nothing to disclose.
James E. Siegler III, MD (University of Chicago) Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.