Canepa Carlo1*, Griffiths Pahet, and Brett James
27-year-old female patient with history of migraine with sensory aura. Approximately four months previous to her admission, her migraines were increasing in frequency; due to this, she increased her dose of sumatriptan. One month previous to her admission, she presented an acute episode of the “worst migraine attack in her life”, without any associated focal neurology. Despite reducing in intensity, the headache persisted from that day onwards. After approximately one week, she developed neurobehavioral changes, which progressively worsened. Her CT on admission showed a hypo density in the right anterior thalamus; an MRI done three days later demonstrated a chronic (>3 weeks old) right thalamic stroke. The “worst migraine of her life” correlates well with the occurrence of the right thalamic stroke. The previously increased dose of sumatriptan seems to have precipitated the event and, the neurobehavioral changes fit nicely with the anterior damage to the thalamus.
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