According to a recent analysis published in the Journal of the Neurological Sciences, Familial hemiplegic migraine type 2 (FHM2) can be associated with cortical hyperintensity/swelling in the clinically altered cerebral hemisphere on cMRI diagnosis. FMH is a unique monogenic kind of migraine with aura with three different genetic subtypes (FHM1-3). There is not much data available regarding imaging studies which could better inform about acute FHM attacks, especially of FHM2 subtype.

Therefore, Christian Roth and colleagues conducted a retrospective analysis to obtain imaging data of FHM2 by selecting four different patients with genetically confirmed FHM2 using two CT and eight cMRI perfusion studies. These studies attained during the six separate attacks.

At all present time-points, the cMRI investigations were found to be without evidence of cytotoxic oedema. Cortical hyperintensity/swelling of the impaired cerebral hemisphere is the most remarkable finding of the T2/FLAIR-weighted MRI. Additional changes, found only in some of the patients, involved elevated perfusion of the affected hemisphere as well as dilatation of the middle cerebral artery. These findings were previously reported especially among the subjects with FHM1. Also, the changes which appeared later on during attacks showed a possible association of extended attack duration.