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Old 11-11-2012
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Question migraine aura and stroke

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A 33-year-old woman is evaluated in the emergency department for paresthesia that began in the left face and spread over 30 minutes to the left arm and leg, clumsiness of the left hand that began 30 minutes ago, and a subsequent right-sided throbbing headache and nausea. This is the first time she has ever had such symptoms. She is otherwise healthy but has a family history of migraine.
this is _____ [ migraine aura \stroke in progression]

* how can we differentiate between 2.... just need strong exam clues .... text says migraine aura is progressive but i think with above presentation, stroke progression can be ans too. ya, she is young and mother has migraine...but are there SOLID OBJECTIVE points to differentiate b\w 2 ?
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Old 11-11-2012
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Originally Posted by tyagee View Post
this is _____ [ migraine aura \stroke in progression]

* how can we differentiate between 2.... just need strong exam clues .... text says migraine aura is progressive but i think with above presentation, stroke progression can be ans too. ya, she is young and mother has migraine...but are there SOLID OBJECTIVE points to differentiate b\w 2 ?
Migraine with aura is a risk factor for stroke.
Look at the patient.. I may sound stupid but look at the order of things and at the chronology, she first started with hemiparesis and then it evolved toward the point of a headache, this headache you present in this particular case for me is secondary to prob intracranial pressure increase and not a migraine per se.

On the other hand if she had started with the typical migraine with aura and then developed the paresthesia then sure..

I really dont get your question but I would look in the chronology of presentation to make a diagnosis.

Migraine with aura does predispose to strokes though...

Sorry If I sounded stupid haha
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Old 11-11-2012
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You sound like a Genius.
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the above patient has migraine aura.
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the above patient has migraine aura.
Where is this question from?
I couldn't find it in UW.
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