可逆性腦血管收縮症候群：個案報告及文獻回顧

Reversible Cerebral Vasoconstriction Syndrome: A Case Report and Literature Review

林倩如(Chien-Ju Lin) ； 林冠佑(Kuan-Yu Lin)

《台灣家庭醫學雜誌》 34卷3期 (2024/09) Pp. 177-184

https://doi.org/10.53106/168232812024093403007

摘要

頭痛為家庭醫學科門診很常見的病人主訴，完整的病史詢問及理學檢查會協助我們判別危急的頭痛徵象，而其中雷擊性頭痛（thunderclap headache, TCH）就是不容忽視的警訊之一。此個案報告分享一位有偏頭痛病史的病人，新發生TCH，在排除其它鑑別診斷後，診斷為可逆性腦血管收縮症候群（reversible cerebral vasoconstriction syndrome, RCVS）。本文針對TCH常見的鑑別診斷及RCVS做簡要的文獻回顧，讓基層醫療醫師對此頭痛主訴及診斷能有所警惕，以做出適當的處置及轉診。

關鍵字

可逆性腦血管收縮症候群 ； 雷擊性頭痛

並列摘要

Headache is a common chief complaint in family medicine clinics. Careful history-taking and physical examination help establish critical headache diagnosis, and thunderclap headache (TCH) is one of the red flag features of headache. This article reported a female patient with a history of episodic migraine who developed new TCH and was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS) after excluding other differential diagnoses. The literature on the evaluation of TCH and diagnosis of RCVS were reviewed herein. This case report may help primary care physicians to be alert to TCH and RCVS for appropriate treatment and referral.

並列關鍵字

reversible cerebral vasoconstriction syndrome ； thunderclap headache

參考文獻

Chen, CY,Fuh, JL(2021).Evaluating thunderclap headache.Curr Opin Neurol.34,356-362.

Ducros, A(2012).Reversible cerebral vasoconstriction syndrome.Lancet Neurol.11,906-917.

Erhart, DK,Ludolph, AC,Althaus, K(2023).RCVS: by clinicians for clinicians-a narrative review.J Neurol.270,673-688.

Singhal, AB(2023).Reversible cerebral vasoconstriction syndrome: A review of pathogenesis, clinical presentation, and treatment.Int J Stroke.18,1151-1160.

Chen, SP,Wang, SJ(2022).Pathophysiology of reversible cerebral vasoconstriction syndrome.J Biomed Sci.29,72.