Perfusion weighted imaging during migraine: spontaneous visual aura and headache

Authors

  • M Sanchez del Rio,

    Corresponding author
      Margarita Sanchez del Rio, Massachusetts General Hospital, 149 13th St., CNY 6403, Charlestown, MA 02129, USA. Tel. +1 617 726 8440, fax. +1 617 726 2547, email. sanchezm@helix.mgh.harvard.edu.
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  • D Bakker,

    1. Stroke and Neurovascular Regulation, Departments of Neurology and Neurosurgery, Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, MA, USA;
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  • O Wu,

    1. Stroke and Neurovascular Regulation, Departments of Neurology and Neurosurgery, Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, MA, USA;
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  • R Agosti,

  • DD Mitsikostas,

  • L Østergaard,

    1. Stroke and Neurovascular Regulation, Departments of Neurology and Neurosurgery, Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, MA, USA;
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  • WA Wells,

    1. Department of Radiology, Massachusetts General Hospital and Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
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  • BR Rosen,

    1. Stroke and Neurovascular Regulation, Departments of Neurology and Neurosurgery, Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, MA, USA;
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  • G Sorensen,

    1. Stroke and Neurovascular Regulation, Departments of Neurology and Neurosurgery, Nuclear Magnetic Resonance Center, Harvard Medical School, Boston, MA, USA;
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  • MA Moskowitz,

  • FM Cutrer


Margarita Sanchez del Rio, Massachusetts General Hospital, 149 13th St., CNY 6403, Charlestown, MA 02129, USA. Tel. +1 617 726 8440, fax. +1 617 726 2547, email. sanchezm@helix.mgh.harvard.edu.

Abstract

Using perfusion weighted imaging, we studied 28 spontaneous migraine episodes; 7 during visual aura (n=6), 7 during the headache phase following visual aura (n=3), and 14 cases of migraine without aura (n=3). The data were analyzed using a region-of-interest-based approach. During aura, relative cerebral blood flow (rCBF) was significantly decreased (27%±0.07) in occipital cortex contralateral to the affected hemifield. rCBV was decreased (15%±0.12) and mean transit time increased (32%±0.3), persisting up to 2.5 h into the headache phase. Other brain regions did not show significant perfusion changes. During migraine without aura, no significant hemodynamic changes were observed. In one patient who experienced both migraine with and without aura, perfusion deficits were observed only during migraine with aura. These findings suggest that decremental blood flow changes in occipital lobe are most characteristic of migraine with aura.

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