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Migrainous encephalopathy is a rare and poorly understood manifestation of the inherited vasculopathy cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Patients may present with migraine with aura, complicated by confusion, fever, and decreased conscious level.1 In this case, a patient with migrainous encephalopathy underwent cerebral perfusion imaging with arterial spin labeling (ASL) MRI before, during, and following admission.
Acknowledgments
Acknowledgment: The authors thank Dr. Rosario Lopez Gonzalez for writing the in house macro to allow quantitative analysis of ASL.
Footnotes
Author contributions: Dr. Moreton drafted the manuscript, analyzed the data, and obtained funding. Dr. Santosh reported the imaging, revised the manuscript, and obtained funding. Dr. McArthur managed the patient and revised the manuscript. Prof. Muir managed the patient, revised the manuscript, and obtained funding.
Study funding: The first MRI scan was funded by a project grant award from the Chief Scientists Office (ETM/244).
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Received April 8, 2015.
- Accepted in final form August 13, 2015.
- © 2015 American Academy of Neurology
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