Chronic Tension-type Headache and Benign Paroxysmal Positional Vertigo Complicated Variants of Posterior Circulation
陳建志(Jiann-Jy Chen)；陳登郎(Dem-Lion Chen)；楊菁華(Chin-Hua Yang)
慢性緊縮型頭痛 ； 良性陣發性姿態性眩暈 ； 後顱窩循環 ； 高血脂症 ； chronic tension-type headache ； benign paroxysmal positional vertigo ； posterior circulation ； hyperlipidemia
|Volume or Term/Year and Month of Publication||
7卷3期（2010 / 09 / 01）
265 - 272
A 61-year-old woman presented having had chronic daily headache for half a year and positional vertigo for one month. She was diagnosed with chronic tension-type headache and benign paroxysmal positional vertigo. However, her blood tests showed hyperlipidemia and a hyperventilation test was able to induce the same type of headache. Furthermore, a vestibular evoked myogenic potential assessment showed a bilaterally delayed latency of the left P13. Finally, a magnetic resonance angiogram showed the presence of several vascular variants of the posterior circulation, including a variation of the posterior circle of Willis, deficient branches of the basilar artery, and hypoplasia with route anomaly of the right vertebral artery. After an Epley's canalith repositioning procedure had cured the vertigo, she received blood lipid control and anti-thrombotic therapy; however she did not receive any non-steroid anti-inflammatory drugs or tri-cyclic anti-depressants. Over the following one month, the blood lipid level decreased and the headaches remitted. The following one and five months were also uneventful. Chronic tension-type headaches are as yet of unknown etiology. For this reason it is important that the patient should heal him/herself. In this case, she was cured by blood lipid control and anti-thrombotic therapy and there is also the possibility that the chronic tensiontype headache was related to the presence of the vascular variants of posterior circulation.