title: Pediatric hemiplegic migraine: role of multiple MRI techniques in evaluation of reversible hypoperfusion.
abstract: BACKGROUND
  Hemiplegic migraine (HM) is a rare type of migraine with aura that involves motor weakness. Data on conventional and advanced neuroimaging findings during prolonged attacks of HM are limited, particularly in children.
  
  
  METHODS
  A 13-year-old-female with a history of migraine had a typical attack of HM characterized by right-sided hemiplegia, deterioration of vigilance and paraphasia. MRI performed 3 hours after hemiplegia onset revealed normal diffusion tensor imaging (DTI) sequences, but perfusion weighted imaging (PWI) showed a large area of hypoperfusion within the left cerebral hemisphere and susceptibility weighted imaging (SWI) demonstrated a matching area with prominent, hypointense draining sulcal veins. Magnetic resonance angiography (MRA) revealed subtle narrowing of the left middle cerebral artery. The neuroimaging abnormalities completely resolved 24 hours after the attack onset.
  
  
  CONCLUSIONS
  Multiple conventional and advanced MRI techniques including SWI play a key role in an HM attack to (1) exclude acute arterial ischemic stroke and (2) further understand the pathophysiology of HM.
authors.affiliation: Section of Pediatric Neuroradiology, Division of Pediatric Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Thangamadhan
authors.initials: T
authors.lastname: Bosemani
authors.forename: Vera J
authors.initials: VJ
authors.lastname: Burton
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Felling
authors.forename: Richard
authors.initials: R
authors.lastname: Leigh
authors.forename: Christopher
authors.initials: C
authors.lastname: Oakley
authors.forename: Andrea
authors.initials: A
authors.lastname: Poretti
authors.forename: Thierry Agm
authors.initials: TA
authors.lastname: Huisman
mesh_terms: D000293:Adolescent; D056324:Diffusion Tensor Imaging; D005260:Female; D006429:Hemiplegia / Q000209:etiology / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D020325:Migraine with Aura / Q000473:pathology*
keywords: Susceptibility weighted imaging; children; hemiplegic migraine; neuroimaging; perfusion-weighted imaging