Dhuna A, Pascual-Leone A, Belgrade M
Department of Neurology, Hennepin County Medical Center, Minneapolis, MN.
J Neurol Neurosurg Psychiatry. 1991 Sep;54(9):803-6. doi: 10.1136/jnnp.54.9.803.
The records of 21 patients admitted to hospital from January 1985 to December 1988 for acute headache associated with cocaine intoxication were reviewed. Fifteen patients were identified who experienced headaches with migrainous features in the absence of neurological or systemic complications. None of them had a history of cocaine-unrelated headaches or a family history of migraine, and all had a favourable outcome. Three possible mechanisms of cocaine-related vascular headaches are discussed which depend on the interval between cocaine ingestion and development of the headache. We postulate that acute headaches following cocaine use may relate to the sympathomimetic or vasoconstrictive effects of cocaine, while headaches following cocaine withdrawal or exacerbated during a cocaine "binge" may relate to cocaine-induced alteration of the serotoninergic system.
回顾了1985年1月至1988年12月因急性头痛伴可卡因中毒入院的21例患者的记录。确定了15例患者，他们在没有神经或全身并发症的情况下出现具有偏头痛特征的头痛。他们中没有人有与可卡因无关的头痛病史或偏头痛家族史，且所有患者预后良好。讨论了可卡因相关血管性头痛的三种可能机制，这些机制取决于可卡因摄入与头痛发作之间的间隔时间。我们推测，使用可卡因后的急性头痛可能与可卡因的拟交感神经或血管收缩作用有关，而可卡因戒断后或在可卡因“狂欢”期间加重的头痛可能与可卡因引起的5-羟色胺能系统改变有关。
