A case of confusional migraine with transient increased cerebral blood flow

Brain Dev. 2019 Jun;41(6):559-562. doi: 10.1016/j.braindev.2019.02.002. Epub 2019 Feb 14.

Abstract

Background: Confusional migraine is a rare type of migraine presenting as an acute confusional state. However, the mechanism of this confusional state remains unclear.

Subject and methods: We examined an 11-year-old girl with confusional migraine, using electroencephalography, brain magnetic resonance imaging, cerebrovascular magnetic resonance angiography, and single-photon emission computed tomography to investigate cerebral blood flow changes.

Results: Our findings revealed vessel narrowing in the left middle and posterior cerebral artery territory, indicating vasospasm and suggesting that the confusion was caused by hypoperfusion. However, abnormal increased cerebral blood flow in the left middle and posterior cerebral artery territory was observed during the non-confusional state.

Conclusion: The recorded cerebral blood flow changes are similar to those associated with migraine attacks, gradually changing from abnormally low to abnormally high during the confusional and post-confusional state.

Keywords: Cerebral blood flow; Confusional migraine; Electroencephalography; Magnetic resonance angiography; Single-photon emission computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Cerebrovascular Circulation / physiology*
  • Child
  • Confusion / physiopathology
  • Electroencephalography / methods
  • Female
  • Humans
  • Magnetic Resonance Angiography / methods
  • Magnetic Resonance Imaging / methods
  • Migraine Disorders / blood
  • Migraine Disorders / complications
  • Migraine Disorders / physiopathology*
  • Tomography, Emission-Computed, Single-Photon / methods