Migrainous infarction

Migrainous Infarction is a rare form of migraine that is classified as a subtype of migraine with aura. It is characterized by the occurrence of an ischemic stroke during a migraine attack.

Definition

Migrainous Infarction is defined by the International Headache Society as a migraine attack that is accompanied by an ischemic stroke, where neuroimaging demonstrates ischemic infarction in a relevant area. The stroke must occur during a typical migraine with aura attack and other causes of stroke must be ruled out.

Epidemiology

Migrainous infarction is a rare condition, accounting for less than 1% of all ischemic strokes. It is more common in women than in men, and typically occurs in individuals under the age of 45. The risk factors for migrainous infarction are similar to those for other types of stroke, including hypertension, smoking, and the use of oral contraceptives.

Pathophysiology

The exact mechanism of migrainous infarction is not fully understood. It is thought to involve a combination of vascular and neuronal factors. During a migraine attack, there is a wave of neuronal depression that spreads across the cerebral cortex, known as cortical spreading depression. This is followed by a period of reduced blood flow to the brain, which can lead to ischemic stroke.

Diagnosis

Diagnosis of migrainous infarction can be challenging, as the symptoms can be similar to those of a typical migraine with aura. Neuroimaging, such as MRI, is necessary to confirm the diagnosis. The presence of an infarction in a relevant area on neuroimaging, in conjunction with a typical migraine with aura attack, is indicative of migrainous infarction.

Treatment

Treatment of migrainous infarction involves managing the acute stroke and preventing future migraine attacks. This may involve the use of antiplatelet drugs, anticoagulants, and migraine medications. Lifestyle modifications, such as quitting smoking and managing hypertension, are also important.

See Also

• Migraine
• Ischemic Stroke
• Cortical Spreading Depression

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