小腦後蛛網膜囊腫併發慢性基底動脈型偏頭痛

成年人反覆發作的眩暈及頭痛需考慮預兆偏頭痛之亞型－基底型偏頭痛，詳盡的病史回顧即可得到答案，影像學檢查並非必要，除非想要用來排除器質性的病灶。一49歲男性苦於每日發作1或2次陣發性的眩暈及整個頭痛8個月求診於本院。所有理學檢查均無異常發現，眼振電圖檢查僅視運動性眼振呈現異常，原本診斷爲慢性基底型偏頭痛，在早晚服用β受器拮抗劑及抗焦慮劑後，慢性基底型偏頭痛可以受到良好的控制，可是，電腦斷層竟意外發現小腦後蛛網膜囊腫，神經外科醫師一直是建議手術治療，但患者拒絕，只好持續保守治療，近來病症已經痊癒，視運動性眼振業已恢復正常。我們認爲，真正造成本個案病症之因應爲慢性基底型偏頭痛，並非小腦後蛛網膜囊腫，故不建議任何形式的手術，除非囊腫繼續擴大。目前尚無文獻闡明偏頭痛與蛛網膜囊腫間的關係，期待未來能有更多的研究與討論。

關鍵字

眩暈；頭痛；視運動性眼振；偏頭痛； β受器拮抗劑

並列摘要

Recurrent vertigo and headache in an adult might be attributable to basilar-type migraine, a subtype of migraine with aura. A detailed history taking is recommended to confirm the disease, but an image study is not necessary unless an organic lesion is highly suspected. A 49-year-old man has been daily bothered by once or twice vertigo and holo-headache for eight months. The symptomatic duration was about four hours. Physical examinations were all unremarkable, but electronystagmogram showed an abnormal optokinetic nystagmus. Then, chronic basilar-type migraine was diagnosed. After he took a β-antagonist and anti-anxiety twice a day, the symptom was controlled, but a computed tomography accidently revealed a retrocerebellar arachnoid cyst; afterwards, our neurosurgeon always suggested a surgical excision for him, but he refused. He has been conservatively treated till the symptom submitted recently. The optokinetic nystagmus recovered. We think chronic basilar-type migraine, rather than the retrocerebellar arachnoid cyst, made him symptomatic, so we do not suggest any surgery for him unless the cyst develops. Although the relationship between migraine and an ararchnoid cyst is yet limited in the literature, it should be addressed in the future.

並列關鍵字

vertigo ； headache ； optokinetic nystagmus ； migraine ； β-antagonist

國際替代計量

小腦後蛛網膜囊腫併發慢性基底動脈型偏頭痛

全文下載

主題瀏覽