Findings in susceptibility weighted imaging in pediatric patients with migraine with aura.

Kellner-Weldon, Frauke; Lehmann, Vera Franziska; Breiding, Philipe Sebastian; Grunder, Lorenz; Muri, Raphaela; Pastore-Wapp, Manuela; Bigi, Sandra; Wiest, Roland; El-Koussy, Marwan; Slavova, Nedelina (2020). Findings in susceptibility weighted imaging in pediatric patients with migraine with aura. European journal of paediatric neurology, 28, pp. 221-227. Elsevier 10.1016/j.ejpn.2020.05.008

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BACKGROUND

Migraine with aura (MwA) in pediatric patients is clinically frequent. Clinically complex symptoms need to be differentiated to exclude mimicking conditions.

PURPOSE

We hypothesize that MwA in children induces abnormalities readily visible in perfusion time to peak (TTP) maps as well as non-enhanced susceptibility weighted magnetic resonance imaging (SWI).

MATERIALS AND METHODS

Between 2010 and 2018, we retrospectively evaluated symptoms and imaging of consecutive pediatric patients <18 years with MwA. We visually scored abnormalities on SWI and TTP maps in 12 regions of interest on both hemispheres on three axial slices, as normal, slightly, distinctly or severely abnormal.

RESULTS

99 patients (69.7% female), mean age 14.07 y (±2.8) were included. Focally increased deoxygenation (FID) in SWI was present in 61.6%. FID on SWI was dominant for the left hemisphere (60.7% vs. 31.1%, (p < .001)), and in 8.2% symmetric. Side of aura symptoms and contralateral hemispheric imaging alterations in patients with FID correlated significantly (p = .002.). 61 of 99 patients had perfusion MR and 59% of these patients showed focal increase of TTP. Age correlated significantly with FID in SWI (r = -.248, p = .013) and increase of TTP in perfusion (r = -.252, p = .05). Focal abnormalities correlated significantly between SWI and TTP maps. Brain regions most often abnormal were the temporal superior, occipital and fronto-parietal regions.

CONCLUSIONS

This study provides confidence in recognizing FID, and linking FID in SWI to acute MwA in pediatric patients. FID phenomenon had a left hemispheric significant dominance, and can be found bilaterally.

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 Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Kellner-Weldon, Frauke; Breiding, Philipe Sebastian; Grunder, Lorenz Nicolas; Muri, Raphaela; Pastore-Wapp, Manuela; Bigi, Sandra; Wiest, Roland; El-Koussy, Marwan and Slavova, Nedelina Bozhidarova

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1090-3798

Publisher:

Elsevier

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

12 Aug 2020 09:34

Last Modified:

19 Oct 2020 01:32

Publisher DOI:

10.1016/j.ejpn.2020.05.008

PubMed ID:

32723685

BORIS DOI:

10.7892/boris.145887

URI:

https://boris.unibe.ch/id/eprint/145887

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