Presentation
Headache, vomiting, right eye deviation and left sided weakness.
Patient Data
Age: 8 years
Gender: Male
From the case:
Hemiplegic migraine
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Asymmetry of cortical veins on the susceptibility weighted sequence, with more prominent veins on the right.
5 punctate foci of supratentorial white matter T2 hyperintensity are evident, none of which demonstrate diffusion restriction.
No intracranial mass lesion. Structurally normal brain.
Case Discussion
The susceptibility findings are consistent with hemiplegic migraine involving the right hemisphere, which accounts for the left sided signs, with no evidence of an acute infarct.