Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance.

Kellner-Weldon, Frauke; El-Koussy, Marwan; Jung, Simon; Jossen, M; Gratz, Pascal P.; Wiest, Roland (2018). Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance. AJNR. American journal of neuroradiology, 39(3), pp. 435-440. American Society of Neuroradiology 10.3174/ajnr.A5508

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BACKGROUND AND PURPOSE Patients diagnosed with migraine with aura have an increased lifetime risk of ischemic stroke. It is not yet clear whether prolonged cortical hypoperfusion during an aura increases the immediate risk of cerebellar infarction because it may induce crossed cerebellar diaschisis and subsequent tissue damage. To address this question, we retrospectively analyzed potential relationships between cortical oligemia and cerebellar hypoperfusion in patients with migraine with aura and their potential relation to small infarct-like cerebellar lesions. MATERIALS AND METHODS One hundred six migraineurs who underwent MR imaging, including DSC perfusion, were included in the study. In patients with apparent perfusion asymmetry, we used ROI analysis encompassing 18 infra- and supratentorial ROIs to account for differences in regional cerebral blood flow and volume. The presence of cerebellar hypoperfusion was calculated using an asymmetry index, with values of >10% being considered significant. RESULTS We observed perfusion asymmetries in 23/106 patients, 22 in patients with migraine with aura (20.8%). Cerebellar hypoperfusion was observed in 12/23 patients (52.2%), and crossed cerebellar diaschisis, in 9/23 patients (39.1%) with abnormal perfusion. In none of the 106 patients were DWI restrictions observed during migraine with aura. CONCLUSIONS Cerebellar hypoperfusion and crossed cerebellar diaschisis are common in patients with migraine with aura and cortical perfusion abnormalities. Crossed cerebellar diaschisis in migraine with aura may be considered a benign phenomenon because we observed no association with DWI restriction or manifest cerebellar infarctions, even in patients with prolonged symptom-related perfusion abnormalities persisting for up to 24 hours.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Kellner-Weldon, Frauke; El-Koussy, Marwan; Jung, Simon; Gratz, Pascal P. and Wiest, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1936-959X

Publisher:

American Society of Neuroradiology

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

09 Apr 2018 14:06

Last Modified:

12 Apr 2019 01:30

Publisher DOI:

10.3174/ajnr.A5508

PubMed ID:

29326138

BORIS DOI:

10.7892/boris.109133

URI:

https://boris.unibe.ch/id/eprint/109133

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