Migraine associated with facial ecchymoses ipsilateral to the symptomatic side

The following is the case of a 55-year-old woman showing palpebral ecchymoses ipsilateral to the symptomatic side during migraine episodes. The lesions are not associated with oedema or other vegetative manifestations. A possible pathogenic mechanism hypothesised is a dermal diapedesis of erythrocytes due to neurogenic inflammation following trigeminovascular activation during migraine crises.