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Silent migraine

Aurélien Quenault, Sara Martinez de Lizarrondo, Olivier Etard, Maxime Gauberti, Cyrille Orset, Benoît Haelewyn, Helen C Segal, Peter M Rothwell, Denis Vivien, Emmanuel Touzé, Carine Ali
SEE SUN ET AL DOI101093/AWW306 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: About 20% of patients with ischaemic stroke have a preceding transient ischaemic attack, which is clinically defined as focal neurological symptoms of ischaemic origin resolving spontaneously. Failure to diagnose transient ischaemic attack is a wasted opportunity to prevent recurrent disabling stroke. Unfortunately, diagnosis can be difficult, due to numerous mimics, and to the absence of a specific test. New diagnostic tools are thus needed, in particular for radiologically silent cases, which correspond to the recommended tissue-based definition of transient ischaemic attack...
January 2017: Brain: a Journal of Neurology
Roel J R Snijder, Justin G L M Luermans, Albert H de Heij, Vincent Thijs, Wouter J Schonewille, Alexander Van De Bruaene, Martin J Swaans, Werner I H L Budts, Martijn C Post
BACKGROUND: A patent foramen ovale (PFO) with atrial septal aneurysm (ASA) has been identified as a risk factor for cryptogenic stroke. Patients with migraine with aura (MA) appear to be at risk for silent brain infarction, which might be related to the presence of a PFO. However, the association between MA and PFO with ASA has never been reported. We examined this association in a large observational study. METHODS AND RESULTS: Patients (>18 years) who underwent an agitated saline transesophageal echocardiography (cTEE) at our outpatient clinics within a timeframe of 4 years were eligible to be included...
December 1, 2016: Journal of the American Heart Association
Szilvia Erdélyi-Bótor, Hedvig Komáromy, David Olayinka Kamson, Norbert Kovács, Gábor Perlaki, Gergely Orsi, Tihamér Molnár, Zsolt Illes, Lajos Nagy, Sándor Kéki, Gabriella Deli, Edit Bosnyák, Anita Trauninger, Zoltán Pfund
BACKGROUND/AIM: Migraine is a risk factor for the formation of silent brain white matter lesions (WMLs) that are possibly ischemic in nature. Although dysfunction of the L-arginine/nitric oxide (NO) pathway has been associated with oxidative stress and endothelial dysfunction in migraine, its role in WML development has not been specifically investigated. Thus, this prospective study aimed to measure the serum concentrations of the NO substrate L-arginine, the NO synthase inhibitor asymmetric dimethylarginine (ADMA), and the L-arginine transport regulator symmetric dimethylarginine (SDMA) in migraine patients in a headache-free period...
May 19, 2016: Cephalalgia: An International Journal of Headache
David Gaist, Ellen Garde, Morten Blaabjerg, Helle H Nielsen, Thomas Krøigård, Kamilla Østergaard, Harald S Møller, Jacob Hjelmborg, Camilla G Madsen, Pernille Iversen, Kirsten O Kyvik, Hartwig R Siebner, Messoud Ashina
A small number of population-based studies reported an association between migraine with aura and risk of silent brain infarcts and white matter hyperintensities in females. We investigated these relations in a population-based sample of female twins. We contacted female twins ages 30-60 years identified through the population-based Danish Twin Registry. Based on questionnaire responses, twins were invited to participate in a telephone-based interview conducted by physicians. Headache diagnoses were established according to the International Headache Society criteria...
July 2016: Brain: a Journal of Neurology
Hille Koppen, Inge H Palm-Meinders, Werner H Mess, Ruud W Keunen, Gisela M Terwindt, Lenore J Launer, Mark A van Buchem, Mark C Kruit, Michel D Ferrari
OBJECTIVE: To assess whether migraine in the general population is associated with increased risk of systemic right-to-left shunts (RLS) and whether RLS are associated with increased prevalence of brain infarcts and persistent recurrence of migraine attacks at older age. METHODS: Brain MRI and transcranial Doppler with air contrast in 166 unselected migraineurs (mean age ± SD 56 ± 7.7 years; 70% women; n = 96 migraine with aura) and 69 controls (mean age ± SD 55 ± 7...
May 3, 2016: Neurology
Wei Du, Xiujuan Wu, Yingqi Xing, Yunlong Geng, Jing Bai, Xiaonan Song
Right-to-left shunt (RLS) is associated with cryptogenic stroke and migraine. Herein we investigated the relationship between RLS and silent lacunar infarcts in patients with migraine. A total of 263 patients with migraine who met eligibility criteria were enrolled from January 2010 to December 2011, among which 127 subjects fell into RLS group. Baseline demographics were comparable between RLS and non-RLS groups (P > 0.05). The incidence of silent lacunar infarcts in RLS group was not significantly different from that of the non-RLS group (25...
2015: BioMed Research International
Sun-Young Oh, Hyo-Jeong Kim, Ji-Soo Kim
Vestibular-evoked myogenic potentials (VEMPs) are short latency manifestations of vestibulo-ocular and vestibulocollic reflexes that originate from the utricle and saccule. Although cervical and ocular VEMPs have mostly been applied to peripheral vestibular disorders, the characteristics and the diagnostic values of VEMPs have been expanded to assess the function of the central otolithic pathways. In the central nervous system, the cervical VEMPs (cVEMPs) are mediated by the vestibular nuclei and uncrossed medial vestibulospinal tract descending in the lower brainstem and spinal cord...
February 2016: Journal of Neurology
Sanjay Prakash, Chaturbhuj Rathore, Prayag Makwana, Mitali Rathod
Transient neurologic dysfunction is a characteristic feature of migraine. About 20% of migraineurs may experience various symptoms in the absence of any headache at one time or another. Visual auras are the most common auras of migraine, and migraine is considered as the most common cause of transient vision loss in young patients. Sensory auras are the second most common migrainous auras. However, the literature is silent for isolated sensory aura as a migraine equivalent. Herein we report 14 patients with recurrent episodic paresthesia in the limbs and other body parts...
September 2015: Headache
Mansoureh Toghae, Elham Rahimian, Mohammad Abdollahi, Saeed Shoar, Mohammad Naderan
OBJECTIVES: To determine the frequency of hyperintense foci in migraine patients and the relationship with migraine headache characteristics and cardiovascular risk factors. METHODS: Ninety patients with migraine headache (70 without aura and 20 with aura) were enrolled and interviewed. Information on their headache (severity, frequency, and mean disease duration) and other related data was obtained by completing a clinical checklist. Subsequently, brain magnetic resonance imaging (MRI) was performed and each patient was then evaluated for hyperintense lesions...
May 2015: Oman Medical Journal
Maurice B Vincent
BACKGROUND: Migraine, a common brain disorder, disrupts vision more than any other motor or sensory function. The possible visual aura symptoms vary from occasional small flashes of light to complex visual hallucinations, the stereotyped teichopsia being the most typical pattern. It is unclear as to why aura occurs serendipitously, sometimes preceding, but also occurring after the headache, and why aura can present with multiple phenotypes. METHODS: To better understand the nature of visual disturbances in migraine, 4 aspects must be considered: What are the visual perceptions in migraine; why vision is affected in migraine; the role of cortical spreading depression (CSD); how does vision could affect migraine...
April 2015: Headache
Donata Guidetti, Eugenia Rota, Nicola Morelli, Paolo Immovilli
Several comorbidities are associated to migraine. Recent meta-analyses have consistently demonstrated a relationship between migraine and stroke, which is well-defined for ischemic stroke and migraine with aura (MA), even stronger in females on oral contraceptives or smokers. However, there seems to be no clear-cut association between stroke in migraineurs and the common vascular risk factors, at least in the young adult population. Migraineurs also run an increased risk of hemorrhagic stroke, while the association between migraine and cardiovascular disease remains poorly defined...
2014: Frontiers in Neurology
Szilvia Erdélyi-Bótor, Mihály Aradi, David Olayinka Kamson, Norbert Kovács, Gábor Perlaki, Gergely Orsi, Szilvia Anett Nagy, Attila Schwarcz, Tamás Dóczi, Sámuel Komoly, Gabriella Deli, Anita Trauninger, Zoltán Pfund
OBJECTIVE/BACKGROUND: The aim of this longitudinal study was to investigate changes of migraine-related brain white matter hyperintensities 3 years after an initial study. Baseline quantitative magnetic resonance imaging (MRI) studies of migraine patients with hemispheric white matter hyperintensities performed in 2009 demonstrated signs of tissue damage within the hyperintensities. The hyperintensities appeared most frequently in the deep white matter of the frontal lobe with a similar average hyperintensity size in all hemispheric lobes...
January 2015: Headache
Anders Hougaard, Faisal Mohammad Amin, Messoud Ashina
PURPOSE OF REVIEW: The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings. RECENT FINDINGS: Brain structure continues to be a topic of extensive research in migraine. Despite advances in neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions...
June 2014: Current Opinion in Neurology
Michael M Dowling, Michael J Noetzel, Mark J Rodeghier, Charles T Quinn, Deborah G Hirtz, Rebecca N Ichord, Janet L Kwiatkowski, E Steven Roach, Fenella J Kirkham, James F Casella, Michael R DeBaun
OBJECTIVE: To identify risk factors for headache and migraine in children with sickle cell disease and test the hypothesis that either or both are independently associated with silent cerebral infarcts. STUDY DESIGN: In this cross-sectional study, we evaluated the health history, laboratory values, and brain magnetic resonance imaging findings of participants with sickle cell disease (hemoglobinSS or hemoglobinSβ°-thalassemia) with no history of overt stroke or seizures...
May 2014: Journal of Pediatrics
Hisao Shimizu, Shuhei Nagami, Nobuyuki Takahashi
A 60-year-old man visited our hospital because of left hemiparesis in September 2006. Magnetic resonance imaging (MRI) revealed a high-intensity lesions in the right corona radiata on diffusion-weighted images and a high-intensity lesions in the basal ganglia and deep white matter on T2-weighted images. He recovered with no sequelae. Antithrombotic agents such as aspirin were given to prevent stroke, but stroke recurred three times over the course of 3 years. In February 2009, neurological examination revealed right hemiparalysis and dysarthria...
2014: Rinshō Shinkeigaku, Clinical Neurology
Junpei Kobayashi, Shoichiro Sato, Kosuke Okumura, Fumio Miyashita, Akihiko Ueda, Yukio Ando, Kazunori Toyoda
The location of white matter lesions, especially in the anterior temporal poles (ATP), is helpful in the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We report a 49-year-old man with CADASIL who developed migraine with atypical aura, silent lacunar infarcts, and leukoencephalopathy without involvement of the ATP. The prevalence of migraine with aura in subjects with CADASIL is several times greater than that in the general population. Particularly in patients with CADASIL, the aura is often atypical (hemiplegic, basilar, or prolonged)...
March 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jakob Møller Hansen, Serapio Michael Baca, Paul Vanvalkenburgh, Andrew Charles
The mechanisms underlying the initiation and propagation of the migraine aura, and the visual percept that is produces, remain uncertain. The objective of this study was to characterize and quantify a large number of visual auras recorded by a single individual over nearly two decades to gain insight into basic aura mechanisms. An individual made detailed drawings of his visual percept of migraine aura in real time during more than 1000 attacks of migraine aura without headache over 18 years. Drawings were made in a consistent fashion documenting the shape and location of the aura wavefront or scotoma in the visual field at one minute intervals...
December 2013: Brain: a Journal of Neurology
Soe Mar, James E Kelly, Sara Isbell, Wint Yan Aung, Jason Lenox, Arthur Prensky
OBJECTIVES: To determine the prevalence of white matter lesions (WMLs) and infarcts in children with migraine and whether pediatric migraine could be a risk factor for silent ischemic lesions or stroke. METHODS: Prospectively collected data from 1,008 pediatric patients with headache were reviewed. The MRI data were collected and retrospectively reviewed. RESULTS: Of the 926 patients diagnosed with migraine, 375 patients had MRIs and 115 had abnormalities, of which 39 had WMLs...
October 15, 2013: Neurology
Asma Bashir, Richard B Lipton, Sait Ashina, Messoud Ashina
OBJECTIVE: To evaluate the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions. METHODS: PubMed as well as the reference lists of identified studies and reviews were used to identify potentially eligible studies through January 2013. Candidate studies were reviewed and eligible studies were abstracted...
October 1, 2013: Neurology
L Calviere, P Tall, P Massabuau, F Bonneville, V Larrue
BACKGROUND AND PURPOSE: Population-based studies have shown a heightened prevalence of clinically silent brain infarcts in subjects who have migraine with aura (MA). We sought to determine whether this association could be confirmed in young patients with cryptogenic ischemic stroke, and explored the role of patent foramen ovale (PFO) as a potential underlying mechanism. METHODS: Patients were selected from a registry of young patients consecutively treated for ischemic stroke in a tertiary university hospital among those without definite cause of stroke...
December 2013: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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