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Cortical swelling of
affected cerebral hemisphere seem to occur during later stages of acute FHM2
attacks and may be associated with prolonged attack duration.
According to a recent analysis published in the Journal of the Neurological Sciences, Familial hemiplegic migraine type 2 (FHM2) can be associated with cortical hyperintensity/swelling in the clinically altered cerebral hemisphere on cMRI diagnosis. FMH is a unique monogenic kind of migraine with aura with three different genetic subtypes (FHM1-3). There is not much data available regarding imaging studies which could better inform about acute FHM attacks, especially of FHM2 subtype.
Therefore, Christian Roth and colleagues conducted a retrospective analysis to obtain imaging data of FHM2 by selecting four different patients with genetically confirmed FHM2 using two CT and eight cMRI perfusion studies. These studies attained during the six separate attacks.
At all present
time-points, the cMRI investigations were found to be without evidence of
cytotoxic oedema. Cortical hyperintensity/swelling of the impaired cerebral
hemisphere is the most remarkable finding of the T2/FLAIR-weighted MRI.
Additional changes, found only in some of the patients, involved elevated
perfusion of the affected hemisphere as well as dilatation of the middle
cerebral artery. These findings were previously reported especially among the
subjects with FHM1. Also, the changes which appeared later on during attacks
showed a possible association of extended attack duration.
Journal of the Neurological Sciences
Multimodal imaging findings during severe attacks of familial hemiplegic migraine type 2
Christian Roth et al.
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