Neuroimaging biomarkers in migraine with aura mimicking stroke: A qualitative and quantitative analysis of perfusion CT alterations.
Objective: Our main goal was to describe the clinical, analytical, and neuroimaging characteristics of a large series of patients with migraine with aura (MA) as stroke mimic (SM). As secondary goals, we evaluated factors associated with perfusion computed tomography (PCT) alterations in MA. Backgro...
| Publicado en: | Headache: The Journal of Head & Face Pain Vol. 66; no. 7; pp. 1607 - 1617 |
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| Autores principales: | , , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195037810&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195037810 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00178748 4AP jtl: Headache: The Journal of Head & Face Pain issn: 00178748 maglogo: Y pubinfo: dt: Jul2026 vid: 66 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 195037810 194417383 195037810 195037810 10.1111/head.70126 195037810 ppf: 1607 ppct: 10 formats: tig: atl: Neuroimaging biomarkers in migraine with aura mimicking stroke: A qualitative and quantitative analysis of perfusion CT alterations. aug: au: de la Escalera, Lucía Gómez Martín Trillo, Santiago del Olmo, Antonio Barbosa de Queirós, Carmen De Benavides Bernaldo Valiente, Esther Gago‐Veiga, Ana Beatriz Sanabria‐Gago, Cristina Nombela, Florentino Gonzalez‐Martinez, Alicia affil: Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain sug: subj: Migraine Radiography Stroke Diagnosis Perfusion Imaging Tomography, X-Ray Computed Neuroradiography Biological Markers Neurologic Manifestations Human Male Female Adult Middle Age Retrospective Design Record Review Nonexperimental Studies Cross Sectional Studies Tertiary Health Care Spain Qualitative Studies Quantitative Studies Cerebrovascular Circulation Diagnosis, Differential Methods Aphasia Etiology Sensation Disorders Metabolism Spain Age Factors Sex Factors Potassium Glucose Creatinine Descriptive Statistics Data Analysis Software T-Tests Pearson's Correlation Coefficient Chi Square Test Fisher's Exact Test Univariate Statistics Exploratory Research Funding Source Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Objective: Our main goal was to describe the clinical, analytical, and neuroimaging characteristics of a large series of patients with migraine with aura (MA) as stroke mimic (SM). As secondary goals, we evaluated factors associated with perfusion computed tomography (PCT) alterations in MA. Background: MA is a frequent SM in the acute setting. Increasing our knowledge and awareness of the clinical and radiological characteristics that may occur in the context of a MA as SM may improve diagnosis and reduce unnecessary treatments such as intravenous thrombolysis. Methods: We conducted a retrospective observational cross‐sectional study including patients with a final diagnosis of MA who were evaluated at a tertiary hospital and stroke center under the stroke code (SC) protocol activation ‐focal neurological symptoms occurring within 24 h‐ between January 1, 2015, and January 31, 2025. Demographic variables (age, sex), clinical features (history of migraine, vascular risk factors, aura type), and biochemical markers (potassium, glucose, and creatinine levels) were collected. Moreover, we explored factors associated with PCT alterations in MA. Results: Among 5513 SC, 68 (1%) were MA, with mean age of 42 (SD: 12.1) years old, 46/68 (68%) females. The most frequent aura symptom was sensory (67%). PCT alterations were found in 15/68 (22%), with a hypoperfusion pattern mainly unilateral, corresponding to a non‐vascular territory. The RAPID automatic software was available in 9/15 (60%) patients. Of these, all patients showed Tmax > 4 s elevation, and one patient also presented Tmax > 6 s elevation. The automatic software analysis identified PCT alterations in five patients that did not show alterations in the qualitative analysis. Male sex (p = 0.003) and aphasic aura (p = 0.004) were associated with PCT alterations in patients with MA. Conclusion: MA as SM forms 1% of SC activation. Automatic RAPID software analysis may help identify PCT alterations that cannot be detected by qualitative analysis. Male sex and aphasia are associated with PCT alterations in MA, which may improve diagnosis in the acute setting. Plain Language Summary: Migraine with aura can mimic a stroke, making diagnosis difficult and sometimes leading to unnecessary treatment in the acute setting. We found that some patients with migraine with aura show characteristic changes on brain perfusion CT scans, particularly in men and those with speech symptoms, which can be better detected using automated analysis software. Recognizing these imaging patterns may help clinicians improve diagnosis and avoid unnecessary interventions associated with an incorrect initial diagnosis. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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