Brain stem and cerebellar hyperintense lesions in migraine.
OBJECTIVE
Migraineurs are at increased risk of cerebellar infarcts and supratentorial white matter lesions. The prevalence, frequency, and distribution of infratentorial hyperintense lesions in migraine are unknown.


METHODS
Migraineurs with aura (n=161), without aura (n=134), and controls (n=140) from a population-based sample of adults (30 to 60 years of age) were evaluated with MRI.


RESULTS
Infratentorial hyperintensities were identified in 13 of 295 (4.4%) migraineurs and in 1 of 140 (0.7%) controls (P=0.04). Twelve cases had hyperintensities, mostly bilaterally, in the dorsal basis pontis. Those with infratentorial hyperintensities also had supratentorial white matter lesions more often.


CONCLUSIONS
We found an increased prevalence of infratentorial (mostly pontine) hyperintensities in migraineurs from the general population. This extends the knowledge about vulnerable brain regions and type of lesions in migraine brains. A hemodynamic ischemic pathogenesis is likely, but further research is needed.
Kruit
Mark C
MC
Department of Radiology, Leiden University Medical Center, PO Box 9600, The Netherlands. m.c.kruit@lumc.nl
Launer
Lenore J
LJ
Ferrari
Michel D
MD
van Buchem
Mark A
MA
D000328:Adult; D001933:Brain Stem / Q000473:pathology*; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis*; D020325:Migraine with Aura / Q000175:diagnosis; D011149:Pons / Q000473:pathology