Kitagawa Masashi, Sato Takeshi, Ishizaki Ryuji, Saiki Masaaki
Department of Neurosurgery, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
No Shinkei Geka. 2006 Jan;34(1):59-64.
Migraine is one of the symptoms frequently encountered in daily neurological and neurosurgical clinical work. Here we report a case of pilocytic astrocytoma in the right occipital lobe presenting as migraine with aura. A 20-year-old female was referred to our hospital with the complaint of a migraine with visual aura. Her symptom did not respond to medical treatment. MRI of the brain disclosed a tumor involving the right occipital lobe. Total removal of the tumor (pilocytic astrocytoma, WHO grade 1) relieved her migraine completely. It has been previously reported that brain tumors are associated with migraine. But this is the first report of occipital pilocytic astrocytoma presenting as migraine with aura. As for other brain tumors manifesting migraine, all of them had focal neurological deficits or symptoms associated with increased intracranial pressure (ICP). The present case stresses the significance of exploration of brain tumor, or other organic abnormalities, even in patients suffering from migraine without neurological deficits or increased ICP symptoms.
偏头痛是日常神经科和神经外科临床工作中经常遇到的症状之一。在此,我们报告一例右侧枕叶毛细胞型星形细胞瘤,表现为伴有先兆的偏头痛。一名20岁女性因伴有视觉先兆的偏头痛前来我院就诊。她的症状对药物治疗无反应。脑部MRI显示右侧枕叶有一个肿瘤。肿瘤(毛细胞型星形细胞瘤,WHO 1级)全切后,她的偏头痛完全缓解。此前已有报道称脑肿瘤与偏头痛有关。但这是首例枕叶毛细胞型星形细胞瘤表现为伴有先兆的偏头痛的报道。至于其他表现为偏头痛的脑肿瘤,所有病例均有局灶性神经功能缺损或与颅内压升高(ICP)相关的症状。本病例强调了即使在没有神经功能缺损或ICP升高症状的偏头痛患者中,也需排查脑肿瘤或其他器质性异常的重要性。