Abstract
Status migrainosus is a migraine complication describing an attack lasting longer than 72 hours. In this paper, we present a case of a 34-year-old female with a history of severe endometriosis and hypercoagulable factor type II disease who presented to the emergency department (ED) with a three-week history of new-onset intractable migraine with aura. Imaging findings revealed a frontal T2/FLAIR hyperintensity, venous anomaly, and bilateral optic nerve thickening. The patient was admitted for three days of inpatient treatment with improvement of her symptoms.
Highlights
Migraine is a highly debilitating disorder, affecting up to 12% of the population annually
We present a case of a 34-year-old female with a history of severe endometriosis and hypercoagulable factor type II disease who presented to the emergency department (ED) with a three-week history of newonset intractable migraine with aura
We present a 34-year-old female with a past medical history of endometriosis, factor II hypercoagulable disorder, and menstrual migraine without aura who presented with three weeks of intractable migraine with neurological features
Summary
Migraine is a highly debilitating disorder, affecting up to 12% of the population annually. In the presence of other comorbidities, the diagnosis of complex migraine becomes challenging and often requires imaging to rule out cerebral-vascular accidents and other pathologies associated with significant morbidity and mortality In this case, we present a 34-year-old female with a past medical history of endometriosis, factor II hypercoagulable disorder, and menstrual migraine without aura who presented with three weeks of intractable migraine with neurological features. We present a 34-year-old female with a past medical history of endometriosis, factor II hypercoagulable disorder, and menstrual migraine without aura who presented with three weeks of intractable migraine with neurological features She described a bilateral squeezing frontal headache that remained at a “7/10” pain severity for three weeks prior to arrival. She was instructed to continue taking topiramate 25 mg three times daily, naproxen 500 mg two times daily as needed, and ubrogepant 100 mg as needed for migraine rescue treatment
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