Published Online
on February 23, 2006

A more recent version of this article appeared on April 1, 2006

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Submitted on November 28, 2005
Accepted on December 20, 2005

Brain Stem and Cerebellar Hyperintense Lesions in Migraine

Mark C. Kruit MD^*; Lenore J. Launer PhD; Michel D. Ferrari MD, PhD; and Mark A. van Buchem MD, PhD

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.).

^* To whom correspondence should be addressed. 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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