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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(12): 896
DOI: 10.1590/0004-282X20170162
Images in Neurology

Sulcal hyperintensity mimicking subarachnoid hemorrhage in the context of hemiplegic migraine

Hiperintensidade de sinal nos sulcos mimetizando hemorragia subaracnoide no contexto de migrânea hemiplégica
Elton Francisco Pavan Batista
1   Universidade Federal do Espírito Santo, Departamento de Radiolodia, Vitória ES, Brasil
,
Marcos Rosa Júnior
1   Universidade Federal do Espírito Santo, Departamento de Radiolodia, Vitória ES, Brasil
,
Marcelo Ramos Muniz
1   Universidade Federal do Espírito Santo, Departamento de Radiolodia, Vitória ES, Brasil
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A 31-year-old woman with migraine had reversible rightsided hemiplegia followed by a throbbing headache on the left side, and underwent a series of MRI scans over an 18-day period.

Hemiplegic migraine is a rare subtype of migraine with aura, presenting with a completely reversible unilateral weakness associated with migraine. This disorder usually has a familial autosomal dominant inheritance trait but, like our patient, can be sporadic. An MRI can show cortical edema, with sulcal hyperintensity on FLAIR ([Figure]), this being rare and of uncertain etiology, possibly due to increased vascular permeability during the aura phase mimicking subarachnoid hemorrhage[1],[2],[3].

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Figure A) First MRI showed no abnormalities; B) Another MRI, one day later, revealed bilateral sulcal hyperintensity in FLAIR in the brain convexities, reversible in the following control MRI; C) two weeks later; D) MR angiography was also normal.


Publication History

Received: 24 December 2016

Accepted: 28 August 2017

Article published online:
01 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

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