Cerebellar Infarction Associated with a Patent Foramen Ovale Revealed by Wallenberg Syndrome During a Migraine Attack

Soumaila Boubacar

doi:10.11648/j.ajpn.20160405.12

Abstract

The occurrence of cerebellar infarction associated with a patent foramen ovale during a migraine attack is rare and ambiguous etiopathogenic explanation. We report the case of a young patient. It was about a 25-years-old, migraine known since age of 8 years, with no particular medical history, admitted to the neurology department of Fann National Teaching Hospital of Dakar for headaches, acute onset of balance and walking disorders in a context of big rotatory dizziness. Neurological examination have objectified a Wallenberg syndrome. The rest of the physical examination was normal. The diagnosis of cerebellar infarction was retained on basis of brain CT and brain MRI. The etiologic test showed patent foramen oval at transoesophageal echocardiography. The diagnosis of migrainous infarction was retained on basis of the young age of the patient, migraine with aura, presence of patent foramen ovale (vascular risk factor etiology?) and lack of any other cause. Patient received anticoagulants and analgesics combined with physical rehabilitation. Outcome was favorable marked by motor recovery. A migrainous infarction, especially cerebellar infarction should be discussed in front of any attack in known migraine with focal neurological signs.

Highlights

Occurrence of a cerebellar infarction associated with a patent foramen ovale (PFO) during a migraine attack is rare and ambiguous etiopathogenic explanation
We report a recent cerebellum infarct case in a young Senegalese man with a patent foramen ovale
The diagnosis of migrainous infarction was retained on basis of the young age of patient, migraine with aura, presence of a patent foramen ovale and absence of any other cause

Summary

Case Report

It was a 25 years old patient, migraine known since the age of 8 years, with no particular medical history, admitted in the neurology department of Fann National Teaching Hospital of Dakar (Senegal, West Africa) for headaches, balance and walking disorders with acute onset in a context of rotary dizziness. The rest of the physical examination was normal. The etiologic tests showed patent foramen oval at transesophageal echocardiography, the rest of complementary exams (electrocardiogram, echocardiography, ultrasound of the supra-aortic arteries, MRI angiography) was normal. The diagnosis of migrainous infarction was retained on basis of the young age of patient, migraine with aura, presence of a patent foramen ovale (vascular risk factor etiology?) and absence of any other cause. The outcome was favorable with regression of balance disorders, decreasing of sustentation’s polygon, a disappearance of dizziness and headache

Discussion

Findings

Conclusion