{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:53:42Z","timestamp":1774954422204,"version":"3.50.1"},"reference-count":35,"publisher":"IMR Press","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Neurol."],"abstract":"<jats:p>Introduction: Migraine aura status is a complication of migraine. It is characterised by the presence of at least 3 episodes of migraine aura within a 3-day period. The pain and\/or associated symptoms are often debilitating. Cortical laminar necrosis (CLN) is a gyriform brain lesion caused by insufficient oxygen and glucose supply, resulting in the loss of cortical neurons, often due to cardiac arrest, global hypoxia, and hypoglycaemia. Metabolic disorders, hypoglycaemia, renal and hepatic dysfunction, and immunosuppressive chemotherapy. In children, cortical laminar necrosis has been linked to the subacute or chronic phase of brain damage due to hypoxic-ischaemic encephalopathy. Metabolic disorders, hypoglycaemia, renal and hepatic dysfunction, and immunosuppressive chemotherapy are included as other possible aetiologies. CLN has also been reported in patients with encephalitis, but it is extremely rare in migraine with or without aura. Clinical Case: We describe a 14-year-old boy with no previous neurological problems who was admitted to our unit due to the onset of acute and persistent symptoms characterised by headache, confusion, dysarthria, aphasia and visual disturbances. An initial emergency brain neuroimaging scan revealed edema localised in the supramarginal gyrus of the left cerebral hemisphere, with possible vascular etiology. A control magnetic resonance imaging revealed laminar necrosis of the cortico-pial area located in the same region. Conclusions: This clinical case is interesting due to the uncommon correlation between cortical laminar necrosis and migraine with aura (MA), the pediatric presentation, the location of hypoperfusion and the atypical progression of the migraine aura. We have reported a narrative review of the two disorders.<\/jats:p>","DOI":"10.31083\/rn47684","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:56:37Z","timestamp":1774950997000},"source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Migraine Aura Status and Cortical Laminar Necrosis: A Clinical Case and a Narrative Review"],"prefix":"10.31083","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0778-2694","authenticated-orcid":true,"given":"Federica","family":"Cernigliaro","sequence":"first","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities \u201cG. D'Alessandro\u201d, University of Palermo, 90127 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Gallo","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Civico-Di Cristina \u2013 Benfratelli Hospital Palermo, 90134 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Alessi","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Civico-Di Cristina \u2013 Benfratelli Hospital Palermo, 90134 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca Maria","family":"Messina","sequence":"additional","affiliation":[{"name":"UOS NPIA \u2013 ASP Trapani, 91016 Erice (TP), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carola","family":"Meo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities \u201cG. D'Alessandro\u201d, University of Palermo, 90127 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edvige","family":"Correnti","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, Civico- Di Cristina -Benfratelli Hospital , 90134 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Craparo","sequence":"additional","affiliation":[{"name":"Neuroradiology Unit, Civico-Di Cristina \u2013 Benfratelli Hospital Palermo, 90134 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6149-0881","authenticated-orcid":true,"given":"Vincenzo","family":"Raieli","sequence":"additional","affiliation":[{"name":"Child Neuropsychiatry Unit, Civico- Di Cristina -Benfratelli Hospital , 90134 Palermo (PA), Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Linde M, Gustavsson A, Stovner LJ, Steiner TJ, Barr\u00e9 J, Katsarava Z, et al. The cost of headache disorders in Europe: the Eurolight project. European Journal of Neurology. 2012; 19: 703\u2013711.","DOI":"10.1111\/j.1468-1331.2011.03612.x"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia: an International Journal of Headache. 2018; 38: 1\u2013211.","DOI":"10.1177\/0333102417738202"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33: 629\u2013808.","DOI":"10.1177\/0333102413485658"},{"key":"ref4","unstructured":"Kumar V, Abbas AK, Aster JC. Robbins & Cotran. Pathologic Basis of Disease. Elsevier Health Sciences: Philadelphia. 2014."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Love S, Louis D, Ellison DW. Greenfield\u2019s Neuropathology. CRC Press: London. 2007.","DOI":"10.1201\/b22602"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Arboix A, Gonz\u00e1lez-Peris S, Griv\u00e9 E, S\u00e1nchez MJ, Comes E. Cortical laminar necrosis related to migrainous cerebral infarction. World Journal of Clinical Cases. 2013; 1: 256\u2013259.","DOI":"10.12998\/wjcc.v1.i8.256"},{"key":"ref7","unstructured":"Faan ARMD, Resnick SJ. Practical Neuroimaging in Stroke. Saunders: Philadelphia. 2009."},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Allen LM, Hasso AN, Handwerker J, Farid H. Sequence-specific MR imaging findings that are useful in dating ischemic stroke. Radiographics: a Review Publication of the Radiological Society of North America, Inc. 2012; 32: 1285\u20131285\u20131297; discussion 1297\u20131299.","DOI":"10.1148\/rg.325115760"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Komiyama M, Nishikawa M, Yasui T. Cortical laminar necrosis in brain infarcts: chronological changes on MRI. Neuroradiology. 1997; 39: 474\u2013479.","DOI":"10.1007\/s002340050448"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Onofri A, Pensato U, Rosignoli C, Wells-Gatnik W, Stanyer E, Ornello R, et al. Primary headache epidemiology in children and adolescents: a systematic review and meta-analysis. The Journal of Headache and Pain. 2023; 24: 8.","DOI":"10.1186\/s10194-023-01541-0"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Eikermann-Haerter K, Dilek\u00f6z E, Kudo C, Savitz SI, Waeber C, Baum MJ, et al. Genetic and hormonal factors modulate spreading depression and transient hemiparesis in mouse models of familial hemiplegic migraine type 1. The Journal of Clinical Investigation. 2009; 119: 99\u2013109.","DOI":"10.1172\/JCI36059"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Eikermann-Haerter K, Lee JH, Yuzawa I, Liu CH, Zhou Z, Shin HK, et al. Migraine mutations increase stroke vulnerability by facilitating ischemic depolarizations. Circulation. 2012; 125: 335\u2013345.","DOI":"10.1161\/CIRCULATIONAHA.111.045096"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"D\u00f6nmez-Demir B, Yemisci M, K\u0131l\u0131\u00e7 K, G\u00fcrsoy-\u00d6zdemir Y, S\u00f6ylemezo\u011flu F, Moskowitz M, et al. Microembolism of single cortical arterioles can induce spreading depression and ischemic injury; a potential trigger for migraine and related MRI lesions. Brain Research. 2018; 1679: 84\u201390.","DOI":"10.1016\/j.brainres.2017.11.023"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Lauritzen M, Dreier JP, Fabricius M, Hartings JA, Graf R, Strong AJ. Clinical relevance of cortical spreading depression in neurological disorders: migraine, malignant stroke, subarachnoid and intracranial hemorrhage, and traumatic brain injury. Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism. 2011; 31: 17\u201335.","DOI":"10.1038\/jcbfm.2010.191"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Black DF, Kung S, Sola CL, Bostwick MJ, Swanson JW. Familial hemiplegic migraine, neuropsychiatric symptoms, and Erdheim-Chester disease. Headache. 2004; 44: 911\u2013915.","DOI":"10.1111\/j.1526-4610.2004.04174.x"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Liang Y, Scott TF. Migrainous infarction with appearance of laminar necrosis on MRI. 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Journal of Neurosciences in Rural Practice. 2019; 10: 559\u2013562.","DOI":"10.1055\/s-0039-1698009"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Haas DC. Prolonged migraine aura status. Annals of Neurology. 1982; 11: 197\u2013199.","DOI":"10.1002\/ana.410110217"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Haan J, Sluis P, Sluis LH, Ferrari MD. Acetazolamide treatment for migraine aura status. Neurology. 2000; 55: 1588\u20131589.","DOI":"10.1212\/wnl.55.10.1588"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Spierings ELH. Flurries of migraine (with) aura and migraine aura status. Headache. 2002; 42: 326\u2013327.","DOI":"10.1046\/j.1526-4610.2002.42402.x"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Martins IP, Goucha T, Mares I, Antunes AF. Late onset and early onset aura: the same disorder. The Journal of Headache and Pain. 2012; 13: 243\u2013245.","DOI":"10.1007\/s10194-012-0419-8"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Viana M, Sprenger T, Andelova M, Goadsby PJ. The typical duration of migraine aura: a systematic review. Cephalalgia: an International Journal of Headache. 2013; 33: 483\u2013490.","DOI":"10.1177\/0333102413479834"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Cupini LM, Stipa E. Migraine aura status and hyperhomocysteinaemia. Cephalalgia: an International Journal of Headache. 2007; 27: 847\u2013849.","DOI":"10.1111\/j.1468-2982.2007.01342.x"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Reinecke RD, Silberstein SD. Migrainous visual auras: a life history. Headache. 2007; 47: 123\u2013127.","DOI":"10.1111\/j.1526-4610.2006.00625.x"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Scutelnic A, Sutter NL, Beyeler M, Meinel TR, Riederer F, Fischer U, et al. Characteristics of acute ischemic stroke and unusual aura in patients with migraine with aura. Headache. 2024; 64: 253\u2013258.","DOI":"10.1111\/head.14682"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Lea\u02dco AAP. Spreading depression of activity in cerebral cortex. Journal of Neurophysiology. 1944; 7: 359\u2013390.","DOI":"10.1152\/jn.1944.7.6.359"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Hadjikhani N, Sanchez Del Rio M, Wu O, Schwartz D, Bakker D, Fischl B, et al. Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proceedings of the National Academy of Sciences of the United States of America. 2001; 98: 4687\u20134692.","DOI":"10.1073\/pnas.071582498"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Viana M, Linde M, Sances G, Ghiotto N, Guaschino E, Allena M, et al. Migraine aura symptoms: Duration, succession and temporal relationship to headache. Cephalalgia: an International Journal of Headache. 2016; 36: 413\u2013421.","DOI":"10.1177\/0333102415593089"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Viana M, Sances G, Linde M, Ghiotto N, Guaschino E, Allena M, et al. Clinical features of migraine aura: Results from a prospective diary-aided study. Cephalalgia: an International Journal of Headache. 2017; 37: 979\u2013989.","DOI":"10.1177\/0333102416657147"},{"key":"ref32","unstructured":"Petrusic I, Zidverc-Trajkovic J. Cortical spreading depression: origins and paths as inferred from the sequence of events during migraine aura. Functional Neurology. 2014; 29: 207\u2013212."},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Raieli V, Capizzi M, Marino A, Di Nardo G, Raucci U, Parisi P. Study on \u201cAtypical\u201d Migraine Auras in the Pediatric Age: The Role of Cortical Spreading Depression and the Physiopathogenetic Hypothesis Arising from Our Clinical Cases. Life (Basel, Switzerland). 2022; 12: 450.","DOI":"10.3390\/life12030450"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"D\u00edaz-P\u00e9rez A, de Eulate NA, Masvidal-Codina E, Illa X, Navarro X, Guimer\u00e0-Brunet A, et al. Cortical spreading depolarizations in stroke: Mechanisms, neuroprotective interventions, and monitoring techniques. GeroScience. 2025.  (online ahead of print)","DOI":"10.1007\/s11357-025-01988-w"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Terrin A, Mainardi F, Maggioni F. The pathological spectrum behind migraine aura status: a case series. 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