Quiz Form

Question Date: 09/09/2023

Question: Migraine like headache is not a feature of which neurological condition?

Options:

• Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)
• MELAS
• Sickle cell disease
• Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL)

Correct Answer: Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL)

Explaination: Migraine is seen in 75% of patients with CADASIL (Cerebral autosomal dominant arteriopathy with subcortical infarcts and leuko encephalopathy). The hallmark is migraine with prolonged and complex aura, and encephalopathy in 10%. Migraine like headache is also seen in MELAS (Mitochondrial encephalomyopathy, lactic acoidosis and stroke) and other mitochondrial disorders. Headache is common in sickle cell disease and 15% fulfill criteria of migraine. Other causes of headache include stroke, cerebral venous sinus thrombosis, bone infarcts in sickle cell crisis etc. Headache is not a feature of CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy). They present with vascular dementia, alopecia and backache.

Reference: Saara Tikka et al. CADASIL and CARASIL. Brain Pathol. 201424(5)525-544.