Saleem Muhammad Azfar, Macdonald R Loch
Division of Neurosurgery, St, Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre of the Li Ka Shing Knowledge Institute of St, Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
J Med Case Rep. 2013 Oct 18;7:244. doi: 10.1186/1752-1947-7-244.
This case highlights the potential importance of new-onset headache, even in the absence of other worrisome features, in a patient with a cerebral aneurysm.
A 61-year-old Caucasian woman presented with nonspecific insidious onset of headache, a superior cerebellar artery aneurysm and cerebrospinal fluid lymphocytosis. She had a subarachnoid hemorrhage 21 days later, at which time the aneurysm had enlarged. The aneurysm was repaired endovascularly and the patient recovered with a modified Rankin score of 1.
This case suggests that new onset of chronic headache in a patient with an unruptured aneurysm may be due to aneurysm growth and can be associated with cerebrospinal fluid lymphocytosis. Headaches are common and may occur incidentally in patients with cerebral aneurysms, but new-onset headache, even if mild, should prompt consideration for timely aneurysm repair.
本病例强调了新发头痛在脑动脉瘤患者中的潜在重要性,即使没有其他令人担忧的特征。
一名61岁的白种女性出现非特异性隐匿性头痛、小脑上动脉动脉瘤和脑脊液淋巴细胞增多症。21天后她发生了蛛网膜下腔出血,此时动脉瘤已经增大。该动脉瘤通过血管内修复,患者恢复后改良Rankin评分为1分。
本病例提示,未破裂动脉瘤患者出现新发慢性头痛可能是由于动脉瘤生长,且可能与脑脊液淋巴细胞增多症有关。头痛很常见,在脑动脉瘤患者中可能偶然发生,但新发头痛,即使是轻度的,也应促使考虑及时进行动脉瘤修复。