Migraine, White Matter Lesions and Subarachnoid Hemorrhage: Analysis of a Large Pedigree

Patients with migraine are at increased risk for white matter hyperintensities detected on magnetic resonance imaging (MRI). A 46-year-old woman had a history of migraine with and without aura for 20 years. Bilateral prominent hyperintense lesions were seen in centrum semiovale, posterior corona radiata, frontal white matter and periventricular regions on her T2- and FLAIR-weighted cranial MRIs. Thirteen members of her family, including her son, had a history of migraine and similar brain MRI lesions. Furthermore, three family members had a history of subarachnoid hemorrhage (SAH) and one member had intracranial aneurysm. Our current knowledge on associations, investigation plan and treatment of patients with migraine with white matter lesions of unknown significance is limited. Herein, for the first time, we report the association of this condition with familial SAH in a large pedigree. (Archives of Neuropsychiatry 2010; 47: 162-5