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(Stroke. 2006;37:1109.)
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Research Reports

Brain Stem and Cerebellar Hyperintense Lesions in Migraine

From the Departments of Radiology (M.C.K., M.A.v.B.) and Neurology (M.D.F.), Leiden University Medical Center, the Netherlands; the Department of Chronic Disease and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven, The Netherlands (L.J.L.); and the Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Md (L.J.L.).

Correspondence to Mark C. Kruit, MD, Department of Radiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail m.c.kruit{at}lumc.nl

Background and Purpose— Migraineurs are at increased risk of cerebellar infarcts and supratentorial white matter lesions. The prevalence, frequency, and distribution of infratentorial hyperintense lesions in migraine are unknown.

Methods— Migraineurs with aura (n=161), without aura (n=134), and controls (n=140) from a population-based sample of adults (30 to 60 years of age) were evaluated with MRI.

Results— Infratentorial hyperintensities were identified in 13 of 295 (4.4%) migraineurs and in 1 of 140 (0.7%) controls (P=0.04). Twelve cases had hyperintensities, mostly bilaterally, in the dorsal basis pontis. Those with infratentorial hyperintensities also had supratentorial white matter lesions more often.

Conclusion— We found an increased prevalence of infratentorial (mostly pontine) hyperintensities in migraineurs from the general population. This extends the knowledge about vulnerable brain regions and type of lesions in migraine brains. A hemodynamic ischemic pathogenesis is likely, but further research is needed.

Key Words: cerebellum • cerebral ischemia • cerebrovascular disorders • magnetic resonance imaging • migraine • Pons

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