Published online Nov 16, 2013. doi: 10.12998/wjcc.v1.i8.256
Revised: September 9, 2013
Accepted: October 16, 2013
Published online: November 16, 2013
Processing time: 106 Days and 14.3 Hours
We present a 29-year-old woman with a long history of attacks of migraine with and without visual aura. She was a heavy smoker (20 cigarettes/d) and was currently taking oral contraceptives. During a typical migraine attack with aura, she developed dysarthria, left brachial hemiparesis and hemihypoesthesia and brief and autolimited left clonic facial movements. Four hours after onset, vascular headache and focal sensorimotor neurological deficit were the only persisting symptoms and, on seventh day, she was completely recovered. Brain magnetic resonance imaging on day 20 after onset showed a subacute ischemic lesion in the right temporo-parietal cortex compatible with cortical laminar necrosis (CLN). Extensive neurological work-up done to rule out other known causes of cerebral infarct with CLN was unrevealing. Only ten of 3.808 consecutive stroke patients included in our stroke registry over a 19-year period fulfilled the strictly defined International Headache Society criteria for migrainous stroke. The present case is the unique one in our stroke registry that presents CLN related to migrainous cerebral infarction. Migrainous infarction can result in CLN.
Core tip: A 29-year-old migrainous woman developed dysarthria and focal sensorimotor neurological deficit during a typical migraine attack with aura. Brain magnetic resonance imaging showed a right temporo-parietal ischemic lesion compatible with cortical laminar necrosis (CLN). The present case is the unique one in our stroke registry over a 19-year period that presents CLN related to migrainous cerebral infarction. Our case shows that CLN can be associated with cerebral ischemia due to migrainous infarction, an infrequent ischemic cerebral infarct of unusual etiology.