FICEF SYMPOSIUM - THE SOCIAL IMPACT OF HEADACHE ON SCHOOL, WORK, AND THE QUALITY OF LIFE Migraine with aura white matter lesions: preliminary data on clinical aspects Alberto Galli 1 • P. Di Fiore 1 • G. D’Arrigo 1 • C. Uggetti 2 • S. Squarza 3 • M. Leone 4 • D. D’Amico 4 • F. Frediani 1 Ó Springer-Verlag Italia 2017 Abstract A few clinic-based magnetic resonance imaging studies report an increased risk of signal abnormalities in migraineurs brain’s white matter, especially in migraine with aura subjects. A vascular genesis has been hypnotized and migraine with aura was considered an independent risk factor for stroke. Available data of magnetic resonance imaging alterations are often nonspecific and sometimes controversial. The aim of our study is to investigate migraine with aura patients with standardized brain mag- netic resonance imaging to detect and to quantify the presence of white matter lesions and to analyze their relation with clinical data. We report preliminary data about first 90 subjects. We did not recognize any clinical aspect in close relationship with these alterations. The only clinical feature that seems to play a role in the presence of alterations is the age, and only in migraineurs women. Keywords Migraine Á Aura Á MRI Á White matter lesions Á WML Introduction Migraine is a common neurological disorder characterized by recurrent attacks of headache. Approximately one-fourth of subjects with migraine complain of transient neurological symptoms, before or during the pain phase, constituting the so-called aura [1–5]. A few clinic-based magnetic resonance imaging (MRI) studies report an increased risk to present diffuse signal abnormalities in migraineurs brain’s white matter, especially in migraine with aura subjects [6]. Different MRI alterations are described: silent posterior circulation territory infarcts, supra-tentorial deep white matter lesions, and infra-tentorial T2-hyperintense lesions. A vascular gen- esis has been theorized and migraine, especially with aura, has been suggested as an independent risk factor for stroke [7, 8]. Available data on MRI abnormality signal features are often nonspecific and sometimes controversial. Some authors also report the changing over time of these white matter abnormalities, sometimes even their disappearance [9, 10]. In a systematic review of literature, we did not find systematic studies about the presence of MRI white matter lesions in migraine with aura patients. In particular fre- quency, pathogenic significance and clinical aspects remain unclear. The aim of this perspective study is to investigate, in a large high selected group of migraine with aura patients, by a specific MRI examinations, the presence of typical white matter lesions, and then to define a correla- tion with clinical data. Materials and methods Since December 2014, we enrolled 122 consecutive patients in accordance with the study protocol approved by our Institute Ethics committee. Subjects’ participant was & Alberto Galli alberto.galli@asst-santipaolocarlo.it 1 Neurological and Stroke Unit Department, Headache Center, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Via Pio II, 3, 20153 Milan, Italy 2 Neuroradiological Unit, Department of Radiology, ASST Santi Paolo e Carlo, S. Carlo Borromeo Hospital, Milan, Italy 3 Post-graduation School in Radiodiagnostics, Universita ` degli Studi di Milano, Milan, Italy 4 Headache Center, Carlo Besta Neurological Institute and Foundation, Milan, Italy 123 Neurol Sci (2017) 38 (Suppl 1):S7–S10 DOI 10.1007/s10072-017-2917-6