Migrainous cerebral infarction: a tomographic study of cerebral blood flow and oxygen extraction fraction with the oxygen-15 inhalation technique.

A patient with migraine who had a permanent visual field defect was studied by angiography and CT scan. He also had a tomographic study of cerebral blood flow (CBF) and oxygen extraction fraction (EO2) using the non-invasive continuous oxygen-15 (15O) inhalation technique. Angiography was normal. CT scan revealed an area of decreased density with contrast enhancement suggestive of a recent infarct in the left occipital lobe. The 15O inhalation technique showed a decrease in CBF and EO2, typical of recent infarcts, in the corresponding area, an increase in CBF with normal EO2 in the left temporal lobe, and a decrease in CBF with increased EO2 in the right occipital cortex. These findings illustrate the unusual nature and extent of the ischemic process underlying migrainous cerebral infarction.