title: Spreading depolarizations in a case of migraine-related stroke.
abstract: BACKGROUND
  Cortical spreading depolarization (CSD) has been implicated in the pathophysiology of migraine with aura. Patients that suffer from this type of migraine have shown a higher risk of developing an ischaemic stroke.
  
  
  METHODS
  A 42-year-old female exhibited reoccurring migraine attacks for the first time 1 month before suffering an ischaemic infarction. Imaging studies revealed an occlusion in the right middle cerebral artery. Other possible disorders were excluded. It was possible to register 20 CSDs, of which 12 coincided with high levels of glutamate and lactate/pyruvate ratio. Loss of electrocorticographic activity was observed for 89 hours after the 8th depolarization.
  
  
  CONCLUSIONS
  Migraine with aura symptoms may be induced by CSDs triggered by hypoperfusion states. Our case supports the idea of the migraine with aura-stroke continuum.
authors.affiliation: Department of Neurosurgery, University of Heidelberg, Germany.
authors.forename: Edgar
authors.initials: E
authors.lastname: Santos
authors.forename: Renán
authors.initials: R
authors.lastname: Sánchez-Porras
authors.forename: Christian
authors.initials: C
authors.lastname: Dohmen
authors.forename: Daniel
authors.initials: D
authors.lastname: Hertle
authors.forename: Andreas W
authors.initials: AW
authors.lastname: Unterberg
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Sakowitz
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis*; D013181:Cortical Spreading Depression; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D020325:Migraine with Aura / Q000175:diagnosis* / Q000209:etiology*