title: Musical murmurs on transcranial ultrasound in childhood migraine with aura.
abstract: A 12-year-old girl presented with headache, nausea, decreased level of consciousness, and diplopia. Brain MRI, arteriography (figure e-1 on the Neurology® Web site at www.neurology.org), vasculitic markers, and CSF were normal, as were EEGs and ECGs. Transcranial color-coded ultrasonography of the basilar artery revealed typical musical murmurs ("seagull cry") indicative of a hemodynamically significant stenosis (video).(1) Sumatriptan provided symptomatic relief; basilar flow normalized on ultrasonography (figure e-2). The clinical presentation suggested childhood migraine with aura; the ultrasound and normal arteriography suggested focal, transient vasospasm during a migraine attack. Topiramate was effective long-term. The high prevalence of childhood migraine (up to >20%)(2) suggests that ultrasound may be a useful diagnostic tool.
authors.affiliation: From the Department of Neurology, University Hospital of Würzburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kraft
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Müllges
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000503:physiopathology; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D002648:Child; D004453:Echoencephalography; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D020325:Migraine with Aura / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D018170:Sumatriptan / Q000627:therapeutic use; D000077236:Topiramate; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014662:Vasoconstrictor Agents; D000077236:Topiramate; D005632:Fructose; D018170:Sumatriptan