Garner B F, Burns P, Bunning R D, Laureno R
Department of Rheumatology, Washington Hospital Center, Washington, DC.
J Rheumatol. 1990 Jan;17(1):93-7.
A 35-year-old woman presented 9 days postpartum with severe headache, arterial hypertension, and left parietal symptoms. A cerebral angiogram revealed widespread irregular areas of narrowing and dilatation, highly suggestive of vasculitis. The hypertension was treated successfully. A repeat angiogram 9 days later was almost completely normal. As this course is inconsistent with isolated cerebral vasculitis, and because the angiogram normalized with antihypertensive therapy, it is likely that the angiographic findings were secondary to hypertension. Experimental data in fact show that acute hypertension can produce areas of cerebrovascular spasm and dilatation. Recognition that angiographic findings suggestive of cerebral vasculitis are nonspecific and may be due to hypertension should prevent unnecessary treatment for vasculitis in such patients.
一名35岁女性产后9天出现严重头痛、动脉高血压及左顶叶症状。脑血管造影显示广泛不规则的狭窄和扩张区域，高度提示血管炎。高血压得到成功治疗。9天后复查血管造影几乎完全正常。由于此病程与孤立性脑血管炎不符，且血管造影在抗高血压治疗后恢复正常，血管造影结果很可能是高血压继发的。事实上，实验数据表明急性高血压可导致脑血管痉挛和扩张区域。认识到提示脑血管炎的血管造影结果是非特异性的，可能由高血压引起，应避免对此类患者进行不必要的血管炎治疗。
