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Case ReportOpen Access
Evidence of Vascular Compromise over the Visual Cortex during Migrainous Headache: A Case Report with MRI Study
Chawalparit O 
,
Siriacharwattana W
,
Siriacharwattana W The objective of the present study was to demonstrate MRI evidence of vascular compromise as seen in a 17-yearold
female presenting with migrainous headache. The patient had been experiencing migrainous headache 2 days ago. She
had visual auras lasting for a few hours before the attack. Upon meeting with her physician she indicated symptoms of left
sided numbness during the headache. No neurological deficit was detected when the first MRI was performed, and all of her
symptoms resolved within 4 days of the attack.
The MRI study showed a focal area of restricted diffusion at the right visual cortex. A short segment of vascular
enhancement was noted on the surface of the affected gyrus. MRS showed a normal N-acetyl aspartate, choline, and creatine
with no elevation of lactate. A follow-up MRI study 5 months later showed normal finding with no residual lesion. The authors
concluded that the abnormality on the first MRI was the ischemic insult of the ictal visual cortex which was transient during
the migraine attack. The pathophysiology was more likely from reversible focal venous congestion.
Keywords: Migraine, Vascular, MRI
female presenting with migrainous headache. The patient had been experiencing migrainous headache 2 days ago. She
had visual auras lasting for a few hours before the attack. Upon meeting with her physician she indicated symptoms of left
sided numbness during the headache. No neurological deficit was detected when the first MRI was performed, and all of her
symptoms resolved within 4 days of the attack.
The MRI study showed a focal area of restricted diffusion at the right visual cortex. A short segment of vascular
enhancement was noted on the surface of the affected gyrus. MRS showed a normal N-acetyl aspartate, choline, and creatine
with no elevation of lactate. A follow-up MRI study 5 months later showed normal finding with no residual lesion. The authors
concluded that the abnormality on the first MRI was the ischemic insult of the ictal visual cortex which was transient during
the migraine attack. The pathophysiology was more likely from reversible focal venous congestion.
Keywords: Migraine, Vascular, MRI
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