Article

Brain stem and cerebellar hyperintense lesions in migraine. Stroke

Department of Radiology, Leiden University Medical Center, PO Box 9600, The Netherlands.
Stroke (Impact Factor: 6.02). 05/2006; 37(4):1109-12. DOI: 10.1161/01.STR.0000206446.26702.e9
Source: PubMed

ABSTRACT Migraineurs are at increased risk of cerebellar infarcts and supratentorial white matter lesions. The prevalence, frequency, and distribution of infratentorial hyperintense lesions in migraine are unknown.
Migraineurs with aura (n=161), without aura (n=134), and controls (n=140) from a population-based sample of adults (30 to 60 years of age) were evaluated with MRI.
Infratentorial hyperintensities were identified in 13 of 295 (4.4%) migraineurs and in 1 of 140 (0.7%) controls (P=0.04). Twelve cases had hyperintensities, mostly bilaterally, in the dorsal basis pontis. Those with infratentorial hyperintensities also had supratentorial white matter lesions more often.
We found an increased prevalence of infratentorial (mostly pontine) hyperintensities in migraineurs from the general population. This extends the knowledge about vulnerable brain regions and type of lesions in migraine brains. A hemodynamic ischemic pathogenesis is likely, but further research is needed.

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    • "In basilar-type migraine, patients exhibit typical brainstem symptoms in the aura phase (Kirchmann et al, 2006). Furthermore, 'hyperintensities' in the brainstem of migraineurs were seen in magnetic resonance imaging investigations more often than in healthy control subjects (Kruit et al, 2006). The neurologic basis for such activations is unclear yet, but depolarizations as shown in this study might be a possible candidate. "
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    • "During this migraine subtype, patients show typical brainstem symptoms in the aura phase (Kirchmann et al, 2006). Furthermore, in magnetic resonance imaging investigations, migraineurs exhibit more 'hyperintensities' in the brainstem than healthy control subjects (Kruit et al, 2006). It may be speculated that these changes are caused by ischemic processes SD in the adult rat brainstem F Richter et al in the brainstem, and that brainstem SDs are involved in the generation of such changes. "
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    • "Whether these findings are clinically relevant, needs to be explored. A tentative correlation , for instance, could be made with previous findings of in previous studies our group has shown our group demonstrating increased prevalence of pontine hyperintensities and cerebellar infarcts in migraineurs from the general population (Kruit et al., 2004, 2006). "
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