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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(09): 597
DOI: 10.1590/0004-282X20200079
Images in Neurology

Migrainous periorbital ecchymosis

Equimose periorbitária na enxaqueca
Sara DUARTE 
1   Centro Hospitalar Universitário do Porto, Hospital de Santo António, Department of Neurology, Porto, Portugal.
,
Carlos ANDRADE 
1   Centro Hospitalar Universitário do Porto, Hospital de Santo António, Department of Neurology, Porto, Portugal.
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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.

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Figure 1 Periorbital ecchymosis after a migraine attack.

The spontaneous periorbital hematoma/ecchymosis in migraine is a rare entity assumed to reflect complex neurovascular changes[1],[2], specifically vasodilation of intracranial and extracerebral blood vessels through the release of vasoactive substances[3].


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Conflict of interest:

There is no conflict of interest to declare.

Authors’ contributions:

Duarte S: manuscript preparation; writing the first draft; critical revision of the manuscript. Andrade A: Conceived the idea of the manuscript; supervision; critical revision of the manuscript.


  • References

  • 1 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
  • 2 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
  • 3 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

Address for correspondence

Sara Duarte

Publication History

Received: 21 April 2020

Accepted: 04 May 2020

Article published online:
13 June 2023

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  • References

  • 1 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
  • 2 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
  • 3 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

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Zoom Image
Figure 1 Periorbital ecchymosis after a migraine attack.