Cerebellar Infarction Associated with a Patent Foramen Ovale Revealed by Wallenberg Syndrome During a Migraine Attack

The occurrence of cerebellar infarction associated with a patent foramen ovale during a migraine attack is rare and ambiguous etiopathogenic explanation. We report the case of a young patient. It was about a 25-years-old, migraine known since age of 8 years, with no particular medical history, admitted to the neurology department of Fann National Teaching Hospital of Dakar for headaches, acute onset of balance and walking disorders in a context of big rotatory dizziness. Neurological examination have objectified a Wallenberg syndrome. The rest of the physical examination was normal. The diagnosis of cerebellar infarction was retained on basis of brain CT and brain MRI. The etiologic test showed patent foramen oval at transoesophageal echocardiography. The diagnosis of migrainous infarction was retained on basis of the young age of the patient, migraine with aura, presence of patent foramen ovale (vascular risk factor etiology?) and lack of any other cause. Patient received anticoagulants and analgesics combined with physical rehabilitation. Outcome was favorable marked by motor recovery. A migrainous infarction, especially cerebellar infarction should be discussed in front of any attack in known migraine with focal neurological signs.