Modi M, Modi G
Department of Radiology and the Neurology Unit, Department of Medicine, the Chris Hani Baragwanath Hospital and the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Headache. 2000 Sep;40(8):677-81. doi: 10.1046/j.1526-4610.2000.040008677.x.
A 25-year-old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four-vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used. She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call-Fleming syndrome. The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.
一名25岁有慢性重度偏头痛伴先兆病史的女性，在其第三个孩子出生1周后出现卒中样状态。她出现严重头痛，并在数小时内陷入昏迷。脑部CT扫描显示脑水肿和枕叶出血。四血管血管造影显示所有颅内血管弥漫性动脉狭窄，双侧颈内动脉鞍上部分节段性狭窄。她没有中风或血管炎的危险因素。她的妊娠和分娩过程顺利，无先兆子痫或子痫。除分娩时使用麦角新碱外，未使用血管收缩药物。她自行康复。脑部系列CT扫描显示水肿和出血消退，同时出现皮质和分水岭梗死。重复脑血管造影正常。因此，她被诊断为患有产后脑血管病，这是一种可逆性脑血管收缩形式，称为Call或Call - Fleming综合征。本文讨论了偏头痛与产后血管病在可逆性脑血管收缩发生过程中的关系。
