偏頭痛合併年輕型腦中風與顱內動脈瘤－病例報告

Migraine Comorbid with Young Stroke and Intracranial Aneurysm: A Case Report

陳建志(Jiann-Jy Chen) ； 張馨丰(Hsin-Feng Chang) ； 陳登郎(Dem-Lion Chen)

《北市醫學雜誌》 12卷1期 (2015/03) Pp. 90-97

https://doi.org/10.6200/TCMJ.2015.12.1.08

摘要

一31歲女性，罹患有預兆與無預兆偏頭痛已經6年，前庭性偏頭痛已經3個月，因發作過兩次垂直性複視而求診，腦部磁振造影檢查意外發現左側小腦之急性梗塞，之後有關年輕型腦梗中風之病因探查並無異常發現，但數位減影血管造影卻發現右側內頸動脈床突旁有一動脈瘤。2週後，患者於外院接受血流轉向支架植入治療。爾後追蹤4個月，不再發作複視，但偏頭痛及前庭性偏頭痛發作依舊。本個案經排除相關致病因素後，反覆偏頭痛發作儼然與急性小腦阻塞性中風及內頸動脈床突旁動脈瘤有顯著相關。文獻中尚無偏頭痛、年輕型腦中風及顱內動脈瘤共同發病之個案報告，本個案誠屬罕見。

關鍵字

年輕型腦中風 ； 偏頭痛 ； 床突旁動脈瘤 ； 小腦梗塞 ； 垂直性複視

並列摘要

A 31-year-old woman suffering from migraine with and without aura for 6 years and vestibular migraine for 3 months presented two episodes of vertical diplopia. Brain magnetic resonance imaging demonstrated an acute left cerebellar infarction. Young stroke survey showed unremarkable findings, but digital subtraction angiogram demonstrated a right internal carotid artery paraclinoid aneurysm. Two weeks later, she received flow diversion device implantation in another hospital. Over the following four months, episodic vertical diplopia did not recur, but migraine and vestibular migraine persisted. After excluding all unlikely causes, the history of recurrent migrainous attacks was the only risk that might contribute to the acute cerebellar infarction and internal carotid artery paraclinoid aneurysm. No previous reports have described the co-occurrence of migraine, young stroke and intracranial aneurysm. The patient we described here demonstrated a rare co-occurrence of diseases.

並列關鍵字

young stroke ； migraine ； paraclinoid aneurysm ； cerebellar infarction ； vertical diplopia