Migraine and arterial dissection in a young woman

Ischemic stroke in young adults is rare (5%-10% of all ischemic strokes) an d, in absence of other risk factors, may be associated with migraine. We de scribe the case of a 34-year-old woman, with a history of migraine without aura, who presented a sudden onset of headache with Homer's syndrome, and i n whom neuroimaging showed evidence compatible with fibromuscular dysplasia (FMD) and arterial dissection of the extracranial internal carotid artery (ICA) and the carotid siphon. In our opinion, in young women with a long hi story of migraine, a careful study of the extracranial and intracranial art eries would be useful, although the cost/benefit ratio does not at present justify such a procedure. Our aim in the future is, therefore, to study a l arger sample of migraine patients in order to find those patients who are m ost at risk of arterial dissection and who should, consequently, be careful ly studied.