Post-stroke migraine

[llogg]

In a patient with no prior history of migraine but a history of stroke, is it common (or even at all heard of) for the patient to develop complicated migraine with focal findings mirroring those of the initial stroke presentation?

I have a patient with a right MCA stroke a couple of years ago who presented with exacerbation of the exact same neuro deficits as he experienced with the stroke but no new focal deficits. He did have a severe headache accompanied by photophobia. CT head negative for hemorrhage, no meningismus, leukocytosis, or fever. Any thoughts?

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[neurologist]

It's not unusual for stroke patients to have resurgence of their initial stroke symptoms during subsquent periods of physiologic stress. This is called an anamnestic effect. I suppose it could happen during migraine. The other question, of course, is whether the initial "stroke" was in fact a complicated migraine to begin with . . .

 

[llogg]

Thanks for the response. The initial stroke pretty clearly was not migraine as he had residual deficits and clear radiologic evidence of ischemia.