偏頭痛腦梗塞

Migrainous Stroke-A Case Report

羅文傑(Wen-Giieh Luo) ； 林健群(Jiann-Chyun Lin) ； 李俊泰(Jiunn-Tay Lee) ； 鄧鐘泉(Jong-Chyou Deug) ； 曹汶龍(Wen-Long Tsao)

《Journal of Medical Sciences》 17卷2期 (1996/10) Pp. 118-122

摘要

偏頭痛雖可引起多種神經症狀，但偏頭痛造成腦中風的病倒在臨床上則不多見。本文報告一年輕未婚31歲女性，平時患有偏頭痛。此次於偏頭痛發作後，發生左側肢體無力、左側半邊舞蹈症（hemichorea）及左側偏盲。腦部電腦斷層及磁振攝影檢查顯示右側視丘、內囊後肢、枕葉及顳葉海馬處梗塞。磁振血管攝影顯示右側後大腦動脈管徑變細及血流降低，經藥物治療後，病情逐漸恢復。由於病史、實驗室及磁振血管攝影檢查排除其他可能的缺血性腦中風可能，故診斷為偏頭痛腦梗塞。文內並討論偏頭痛產生腦梗塞的流行病學、致病機轉、危險因子及治療、預防方法。

關鍵字

偏頭痛 ； 腦梗塞

並列摘要

Although migraine is common in the young adults, it rarely constitutes a significant health risk to the patient. Nevertheless, migraine can lead to catastrophic neurologic consequences. Herein, we describe an unusual case of migraine stroke in a 31 year-old unmarried female. She suffered from recurrent attack of common migraine for many years. She had left hemiplegia, hemianopsia and hemichorea after a migraine attack. CT scan and MRI studies revealed multiple low density lesions over the right thalamus, internal capsule, hippocampus, and occipital lobe. MRA disclosed small caliber and decreased blood flow of right posterior cerebral artery. Series examinations including VORL, HIV, C3, C4, ANA, ESR, CXR, EKG, cardioechogram, and CSF studies showed unremarkable. After medical treatment, her neurological deficits improved gradually. She did not had another cerebral ischemic attack in spite of occasional migraine attack. The epidemiology, risk factors, treatment and pathogenesis of migraine stroke are also discussed in the text.

並列關鍵字

migraine ； stroke