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Migraine With Vasospasm and Delayed Intracerebral Hemorrhage
Andrew J. Cole, MD;
Michel Aubé, MD
Arch Neurol. 1990;47(1):53-56.
Abstract
• Three women with well-documented migraine associated with intracerebral hemorrhage are described. In each case, migraine headaches began during adulthood. Unusually severe and protracted headache heralded the onset of fixed neurological deficits associated with lobar intracerebral hemorrhage. Striking carotid artery tenderness was characteristic. Except for a history of migraine, no cause for intracerebral hemorrhage could be established. In each case arteriography showed extensive spasm of the appropriate extracranial or intracranial artery. Surgical pathology following evacuation of two hematomata demonstrated signs of vessel wall necrosis associated with subacute inflammatory changes. Vasospasm associated with severe migraine attacks may result in ischemia of intracranial vessel walls, leading to necrosis and subsequent vessel rupture when perfusion pressure is restored.
Author Affiliations
From the Montreal (Canada) Neurological Hospital and Institute. Dr Cole is now with the Departments of Neurology and Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, Md.
Footnotes
Accepted for publication April 24, 1989.
Reprint requests to Department of Neuroscience, The Johns Hopkins University School of Medicine, 725 N Wolfe St, Baltimore, MD 21205 (Dr Cole).
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