[Migraine crisis and neurological focal signs of slow or absent resolution (complicated migraine)].

Sixteen cases of vascular headache of the migraine type are referred in whom marked neurological manifestations occurred in a unilateral distribution as part of a migraine attack ("complicated migraine"). The neurologic disorders observed, in order of frequency, include 10 cases of motor hemiparesis, 3 cases of unilateral cerebellar syndrome, 1 case of sensory-motor hemiparesis and 1 case showing signs of the involvement of the motor nuclei of the bulb. The recovery of the motor, sensory, cerebellar and brainstem defects was very slow (average duration: 44.25 days; mode: 14 days) in twelve cases. Two patients showed residual neurological signs respectively after 1 and 7 years from the migraine attack. The patients histories indicate classic or common migraine with a relatively high frequency (80% of the patients experienced one or more crises per month). The most of cases (75%) were female patients. The patients, at time of the attack of complicated migraine, had a mean age years of 32. In ten cases first-grade relatives suffered from classic or common migraine; in no case was there any report of associated or complicated migraine among the relatives. In 4 of the 16 cases the CT scan showed an area of hypodensity consistent to the region of the brain expected to be suffering in view of the clinical type of neurological defect. The Authors take into consideration the controversial relation between complicated migraine with slow or incomplete resolution of neurologic signs and focal brain ischemia due to atherothrombotic infarct, pointing out that the present state of knowledge prevents the reaching of final conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)