Reversible CT perfusion abnormalities in patient with migraine variant: A two phase process

Abstract

The pathophysiology of migraine is not well understood. A rimarily “vascular” theory, proposing that migraine auras are ssociated with vasoconstriction and “oligemia” has given way o a theory of complex neurochemical processes leading to ypometabolism and decreased blood flow termed a “spreadng cortical depression” [1]. Localized decreasing flow, as well as ortical hypometabolism, preferentially affecting the posterior cirulation, has been measured using multiple imaging modalities. The neuroimaging of migraine has helped bolster theories of he nature of the underlying physiological processes, which correate with the well-known clinical manifestation of this common, et mysterious disorder. We present a patient with migraine assoiated with hemispheric cerebral hypoperfusion and stroke-like ymptoms in whom noninvasive dynamic perfusion computed omography (CT) imaging helped determine treatment options. The ynamic changes in CT perfusion seen in cases of migraine varints may help us understand the process of this disorder. Although RI easily rules out many stroke mimics, routine CT scans (done ithout perfusion studies) are often the only imaging done prior to iving thrombolytics.