以頭痛呈現之顱內動脈瘤破裂

Headache Due to Intracranial Aneurysm Rupture

林俊良(Chun-Liang Lin)

《北市醫學雜誌》 8卷1期 (2011/03) Pp. 55-60

https://doi.org/10.6200/TCMJ.2011.8.1.06

摘要

頭痛就像背痛或腹痛一樣，它是一個症狀，背後可能有不同的原因，它有可能只是原發性緊張型頭痛或是偏頭痛，但也有可能是顱內逐漸發展而成的病變，如顱內動脈瘤或腦瘤。在臨床執業上，獲得一個完整而正確的病史是重要且必要的。而突發性頭痛重要的因素必須考慮是顱內動脈瘤破裂造成的腦出血或蜘蛛網膜下腔出血，腦瘤或動靜脈畸型，動脈剝離及腦下垂體造成的出血。－16歲青少年，第一次因急性頭痛伴隨嘔吐住院，過去並無相關病史，身體及神經學檢查皆正常，腦部電腦斷層掃描顯示右側顳葉出血。可見這種未曾發生過的突發性頭痛就暗示著潛藏生命危險的次發性頭痛，而需要作緊急的評估檢查。

關鍵字

頭痛 ； 顱內動脈瘤 ； 蜘蛛網膜下腔出血

並列摘要

Headache, like back pain or abdominal pain, is a symptom that can have many causes. It can be a primary disorder, such as migraine or a tension-type headache. It may also be a symptom of an evolving intracranial disorder, such as an intracranial aneurysm or a brain tumor. Obtaining a complete and accurate history is important and necessary when examining a patient who is complaining of headaches and this takes practice. The important etiologies of sudden onset headache that need to be considered include a ruptured aneurysm with intracranial hemorrhage, subarachnoid hemorrhage, a hemorrhage into a mass or an arteriovenous malformation, arterial dissection and pituitary apoplexy. A 16-year-old teenager was admitted to our hospital because of an acute onset headache that was associated with vomiting. There was no other relevant history. He showed no abnormal physical and neurological signs. A brain computed tomographic scan showed a hematoma of right temporal lobe. In this case, an unexpected abrupt onset headache that had not occurred before was indicative of a potentially life-threatening secondary headache syndrome that required urgent investigation.

並列關鍵字

headache ； intracranial aneurysm ； subarachnoid hemorrhage