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Clinical and Radiologic Features in 26 Cases With Comments on Differentiation From Migraine

B. Todd Troost, MD; Thomas H. Newton, MD

Arch Ophthalmol. 1975;93(4):250-256.

Abstract
The differentiation of migraine headache, preceded by visual aura, from cerebral arteriovenous malformation (AVM) is often regarded as difficult. A study of 26 patients with occipital lobe AVM revealed two distinct syndromes in 18 patients—occipital epilepsy and occipital apoplexy.

Occipital epilepsy is characterized either by elementary visual phenomena, such as brief flashes of light, or by dimming of a homonymous field. Occipital apoplexy results from hemorrhage and hematoma formation within the occipital lobe and is characterized by sudden headache and homonymous visual field loss. We conclude that patients harboring occipital AVMs may, indeed, have visual phenomena and headache that should not be confused with migraine because either a history of generalized seizure or bruits on examination will probably be present.

Author Affiliations
From Veterans Administration Hospital, Miami, and the Department of Neurology, University of Miami (Dr. Troost) and the Department of Radiology, University of California Medical Center, San Francisco (Dr. Newton).

Footnotes
Submitted for publication March 6, 1974.

Reprint requests to Veterans Administration Hospital (180), 1201 NW 16th St, Miami, FL 33125 (Dr. Troost).

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