Nagurney John T, Feldman David, Cahill Daniel P, Gatha Nehal M, Koroshetz Walter J
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, 02115, USA.
J Emerg Med. 2006 Aug;31(2):169-71. doi: 10.1016/j.jemermed.2005.09.014.
We present a previously unreported set of symptoms in a patient found to have bilateral vertebral dissections. Although visual symptoms are common in vertebral dissection, their pattern does not typically mimic those that commonly precede or accompany migraine headache. When they do occur, they usually take the form of diplopia or blurred vision. The patient we describe had visual symptoms that varied over three episodes of headache and included transient visual field loss and scintillations ("lightning bolts"), both common in migraine. However, our patient's new visual symptoms represented a change in pattern from those that had accompanied her previous migraines. This detailed history-taking prompted an evaluation for an etiology other than migraine and prevented a further delay in diagnosis and treatment.
我们报告了一名被发现患有双侧椎动脉夹层的患者出现的一组此前未报道过的症状。虽然视觉症状在椎动脉夹层中很常见，但其表现形式通常并不模仿偏头痛发作前或发作时常见的症状。当这些视觉症状出现时，通常表现为复视或视力模糊。我们所描述的这名患者的视觉症状在三次头痛发作过程中有所变化，包括短暂性视野缺损和闪光（“闪电”），这两种症状在偏头痛中都很常见。然而，我们患者的新视觉症状与她之前偏头痛发作时伴随的症状在模式上有所不同。这种详细的病史采集促使对偏头痛以外的病因进行评估，并避免了诊断和治疗的进一步延误。
