LATE-LIFE MIGRAINE ACCOMPANIMENTS AS A CAUSE OF UNEXPLAINED TRANSIENT ISCHEMIC ATTACKS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 7  (1) , 9-17
Abstract
Occasionally patients in the stroke age-bracket over 40 have unexplained transient cerebral ischemic attacks in association with normal cerebral angiograms. From this group 120 patients were studied in whom the transient episodes resembled the neurological accompaniments of migraine. According to symptoms, the patients were categorized as follows: visual accompaniments (patients with only ordinary scintillating scotoma were excluded), 25; visual and paresthesias, 18; visual and speech disturbance, 7; visual, and brain stem symptoms, 14; visual, paresthesias and speech disturbance, 7; visual, paresthesias, speech disturbance and paresis, 25; recurrence of old stroke deficit, 9; miscellaneous, 8. In establishing the diagnosis, angiography is advisable in all but classical cases. Typical of migrainous accompaniments are the buildup and migration of visual scintillations, the march of paresthesiae and progression from one accompaniment to another, characteristics that do not occur in thrombosis and embolism. Diagnosis is facilitated when 2 or more similar episodes have occurred or migraine-like scintillations are present. Headache occurred in 50% of cases. Other cerebrovascular processes, coagulation disorders and cerebral seizures must be ruled out.

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