A 27-year-old woman, with migraine with aura since age 9, developed two episodes of alternating periocular ecchymosis, with one-month interval, which happened a few hours after the headache onset (Figure 1). The pain lasted more than usual (48 to 72 hours), and the ecchymosis persisted from three to four days. After over two years of follow-up, there was no recurrence of such episodes.
The spontaneous periorbital hematoma/ecchymosis in migraine is a rare entity assumed to reflect complex neurovascular changes11. Shevel E. The extracranial vascular theory of migraine - a great story confirmed by the facts. Headache. 2011 May;51(3):409-17. https://doi.org/10.1111/j.1526-4610.2011.01844.x
https://doi.org/https://doi.org/10.1111/...
,22. Obermann M, Yoon MS, Dommes P, Kuznetsova J, Maschke M, Weimar C, et al. Prevalence of trigeminal autonomic symptoms in migraine: a population-based study. Cephalalgia. 2007 Jun;27(6):504-9. https://doi.org/10.1111/j.1468-2982.2007.01316.x
https://doi.org/https://doi.org/10.1111/...
, specifically vasodilation of intracranial and extracerebral blood vessels through the release of vasoactive substances33. Kalendovsky Z, Austin JH. Changes in blood clotting systems during migraine attacks. Headache. 1977 Jan;16(6):293-312. https://doi.org/10.1111/j.1526-4610.1976.hed1606293.x
https://doi.org/https://doi.org/10.1111/...
.
References
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1Shevel E. The extracranial vascular theory of migraine - a great story confirmed by the facts. Headache. 2011 May;51(3):409-17. https://doi.org/10.1111/j.1526-4610.2011.01844.x
» https://doi.org/https://doi.org/10.1111/j.1526-4610.2011.01844.x -
2Obermann M, Yoon MS, Dommes P, Kuznetsova J, Maschke M, Weimar C, et al. Prevalence of trigeminal autonomic symptoms in migraine: a population-based study. Cephalalgia. 2007 Jun;27(6):504-9. https://doi.org/10.1111/j.1468-2982.2007.01316.x
» https://doi.org/https://doi.org/10.1111/j.1468-2982.2007.01316.x -
3Kalendovsky Z, Austin JH. Changes in blood clotting systems during migraine attacks. Headache. 1977 Jan;16(6):293-312. https://doi.org/10.1111/j.1526-4610.1976.hed1606293.x
» https://doi.org/https://doi.org/10.1111/j.1526-4610.1976.hed1606293.x
Publication Dates
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Publication in this collection
21 Sept 2020 -
Date of issue
Sept 2020
History
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Reviewed
14 Mar 2020 -
Received
21 Apr 2020 -
Accepted
04 May 2020