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Research ArticlePediatric Neuroimaging

Time Course of Cerebral Perfusion Changes in Children with Migraine with Aura Mimicking Stroke

K.M. Cobb-Pitstick, N. Munjal, R. Safier, D.D. Cummings and G. Zuccoli
American Journal of Neuroradiology June 2018, DOI: https://doi.org/10.3174/ajnr.A5693
K.M. Cobb-Pitstick
aFrom the Department of Pediatrics (K.M.C.-P., N.M., R.S., D.D.C.), Division of Child Neurology
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  • ORCID record for K.M. Cobb-Pitstick
N. Munjal
aFrom the Department of Pediatrics (K.M.C.-P., N.M., R.S., D.D.C.), Division of Child Neurology
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  • ORCID record for N. Munjal
R. Safier
aFrom the Department of Pediatrics (K.M.C.-P., N.M., R.S., D.D.C.), Division of Child Neurology
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D.D. Cummings
aFrom the Department of Pediatrics (K.M.C.-P., N.M., R.S., D.D.C.), Division of Child Neurology
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G. Zuccoli
bDivision of Pediatric Neuroradiology (G.Z.), Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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    Fig 1.

    Modified ASPECTS system with 11 ROIs centered in the cortex at 2 contiguous levels on ASL imaging.

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    Fig 2.

    Time course of the brain perfusion changes in migraine with aura from symptom onset.

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    Fig 3.

    Patient 1. ASL demonstrates left hemispheric hypoperfusion (A). Note hypo-oxygenated cortical veins on SWI along the left cerebral hemisphere (B). MRA demonstrates thinning of the distal branches of the left MCA and posterior cerebral artery (C).

Tables

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  • Clinical and MRI findings in a cohort of patients presenting with atypical migraine

    Patient No.Age (yr)SexSymptomsTime of MRI from Symptom Onset (min)SWIMRAASL rCBF (mL/100 mg/min)
    110FR paresis180↓↓a−73
    213FR paresis/anesthesia660Normal↑87
    313ML paresis/anesthesia285↓↓a−15.8
    412FL anesthesia240↓↓−29.3
    514MR paresis510↓↓−9.0
    615FR paresis/anesthesia300↓↓b−31.7
    713MR paresis330Normal↓20.2
    89ML anesthesia465↓↓−50.1
    99ML paresis285↓↓a−47.1
    1015FR paresis/anesthesia240NormalNormal−0.4
    1116MR paresis/anesthesia450NormalNormal19.2
    1212FR paresis/anesthesia250NANA−22.8
    • Note:—L indicates left; R, right; SWI ↓, hypointensity; MRA ↓, decreased arterial caliber in the MCA territory; MRA ↑, increased arterial caliber in the MCA territory.

    • ↵a Additional decrease in caliber of the posterior cerebral artery.

    • ↵b Additional decrease in caliber of the posterior and anterior cerebral arteries.

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Cite this article
K.M. Cobb-Pitstick, N. Munjal, R. Safier, D.D. Cummings, G. Zuccoli
Time Course of Cerebral Perfusion Changes in Children with Migraine with Aura Mimicking Stroke
American Journal of Neuroradiology Jun 2018, DOI: 10.3174/ajnr.A5693

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Time Course of Cerebral Perfusion Changes in Children with Migraine with Aura Mimicking Stroke
K.M. Cobb-Pitstick, N. Munjal, R. Safier, D.D. Cummings, G. Zuccoli
American Journal of Neuroradiology Jun 2018, DOI: 10.3174/ajnr.A5693
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