The main goal of our study was to gain knowledge on blood supply changes during an attack in patients with migraine without aura using contrast-enhanced perfusion-weighted MRI (PWI). Standard MRI, and PWI were performed twice: during an attack (in all three cases) and in between attacks (in two cases). Three females with long history of migraine without aura were observed. Cerebral blood volume (CBV), mean transit time of the contrast bolus (MTT), and cerebral blood flow (CBF) were calculated using Functool package. All three cases produced similar local MR perfusion changes that included reduced CBV and decreased CBF without any change in MTT. Cerebral blood supply decrease observed during migraine attack is reversible and absent during headache-free interval. Transient perfusion abnormalities occurring during recurrent attacks and confirmed by PWI may serve as one of the mechanisms causing the small subcortical white matter lesions.
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