Sharif Muhammad, Trinick Tom, Khan Khurum Hayat
Cardiology Royal Victoria Hospital, Belfast, UK.
J Pak Med Assoc. 2010 Feb;60(2):131-3.
Although patho-physiology of spontaneous internal carotid artery dissection (sICAD) is largely unknown, an association with migraine has been suggested but not proven. Migraine is a condition which is worth considering while one is hunting a possible cause for internal carotid artery dissection (ICAD) and it may be found more often than expected. To date it remains a diagnosis of exclusion in patients with migraine. As opposed to migraine with aura, migraine without aura is significantly more frequent among patients with SICAD. It has been suggested that ICAD produces stroke in 36-68% of patients as a result of occlusion of the artery at or near the site of the dissection, or embolization occurring distally from a dislodged fragment of thrombus. We report a 31-year-old woman with headache and ptosis as initial symptoms. Magnetic resonance imaging (MRI) confirmed the diagnosis. Prompt treatment was instituted with anti-platelet agents and the patient had complete resolution of symptoms. Our case report highlights the importance of identifying the patients with ICD with history of migraine, in the absence of other risk factors and adds to the sparse literature currently available on the subject.
虽然自发性颈内动脉夹层（sICAD）的病理生理学在很大程度上尚不清楚，但偏头痛与之的关联已被提出但未得到证实。偏头痛是一种在寻找颈内动脉夹层（ICAD）可能病因时值得考虑的情况，而且其发现频率可能比预期更高。迄今为止，偏头痛患者仍需排除其他疾病才能确诊。与有先兆偏头痛相反，无先兆偏头痛在sICAD患者中更为常见。有人提出，ICAD在36%至68%的患者中会导致中风，原因是夹层部位或附近的动脉闭塞，或血栓碎片脱落导致远端栓塞。我们报告了一名31岁女性，最初症状为头痛和上睑下垂。磁共振成像（MRI）确诊了病情。立即使用抗血小板药物进行治疗，患者症状完全缓解。我们的病例报告强调了在没有其他危险因素的情况下，识别有偏头痛病史的ICD患者的重要性，并为目前关于该主题的稀少文献增添了内容。
