Basilar Artery Migraines are
Rare, but Potentially Dangerous

Health & Science

Ask Dr. H. By Mitchell Hecht

Question: My daughter had a sudden headache with loss of the use of her right side, slurring of speech, and facial muscle weakness. Hospital tests indicated that she hadn't had a stroke. About five weeks later, she was again hospitalized with the same symptoms. She was finally diagnosed as having an unusual type of a migraine headache, known as a basilar artery migraine. What can you tell me about this?

Answer: This is a very interesting and unusual type of migraine headache, because it's one of those rare examples of a migraine that can cause "mini-strokes" or even a stroke.

Basilar artery migraines are pretty rare, occurring in 1 out of every 500 clinically diagnosed migraine cases. In a migraine headache, there's an initial abnormal dilation of blood vessels in the brain, followed by a spasm of the blood vessel with a transient decrease in blood flow.

The basilar artery is located in the back of the head. It serves the part of the brain that includes the visual center and the cerebellum, or balance center.

Double-vision, vertigo, and a loss of balance with an unsteady gait are therefore frequent symptoms in a basilar artery migraine. Branches of the basilar artery also are involved in hearing, and so symptoms of ringing in the ears or decreased hearing may be present. Other symptoms can include one-sided eyelid drooping; weakness or paralysis of one side of the body; amnesia; confusion; even loss of consciousness.

If the migraine isn't treated, and the symptoms persist, the prolonged deficiency of blood can ultimately result in a stroke. In terms of what we can do, preventive medication is the best strategy. Since there's a definite risk of stroke if the symptoms become severe, drugs such as aspirin, Ticlid, Plavix, or blood thinners such as Coumadin are generally prescribed. Propranolol, a blood pressure medication, is a widely used preventive agent to help counteract basilar artery spasms. Drugs such as caffeine, Ergotamine, Fiorinal, Fioricet, Imitrex, tranquilizers, codeine, and Demerol have varying degrees of success and risk.

To learn more, you can contact the National Migraine Disease Awareness Group at 703-349-1929.

Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: Box 767787, Atlanta, GA. 30076. For a personal reply, include a stamped, self-addressed envelope.

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