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].
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.
