MIGRAINE-LIKE HEADACHE WITH VISUAL DEFICIT AND PERFUSION ABNORMALITY ON MRI

Abstract

Migraine with prolonged aura can mimic an acute ischemic stroke (AIS), as each may present with accompanying headache and focal neurologic deficits. During the acute episode, perfusion imaging like perfusion-weighted MRI (PWI) can show focal abnormalities corresponding to the neurologic deficits in both entities, making clinical distinction challenging, especially considering the time urgency of AIS treatment. In this case report, we discuss how we utilized hyperacute PWI in conjunction with clinical reasoning to propose the diagnosis of migraine-like headache with prolonged aura.