"TIA" or migraine in a woman with no risk factors for cerebral vascular disease.
A 48-year-old female presented to an emergency room with symptoms of episodic hemianopsia, dysphasia, and facial numbness. She had no obvious risk factors for cerebral vascular disease but was admitted into the hospital with a diagnosis of transient ischemic attack (TIA). A neurologist reviewed her history and discovered the additional history of bilateral head pressure accompanying her symptoms. The additional diagnosis of complex migraine with aura was added to the differential diagnosis. Migraine with aura is associated with many neurologic symptoms and can mimic stroke and TIA. Migraine-induced stroke is also described in the literature. The complex presentation of some episodes of migraine makes attention to a detailed history paramount for assessing the patient for diagnosis and for risk selection. Recent studies have demonstrated an association between migraine headaches and cardiovascular morbidity and mortality. The attributable mortality risk for migraine-induced stroke is very low.
Heidenreich
Wayne F
WF
Northwestern Mutual, 720 East Wisconsin Avenue, Milwaukee, WI, 53202, USA. wayneheidenreich@northwesternmutual.com