Kim Yeon-Jung, Kwon Sun U
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea.
Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
Cephalalgia. 2015 Jul;35(8):728-34. doi: 10.1177/0333102414553820. Epub 2014 Oct 15.
Status migrainosus (SM) and persistent aura (PA) without infarction are complications of migraine. Although several patients have been reported to have reversible brain lesions associated with complications of migraine, their nature and pathophysiology remain unclear.
We report on a 38-year-old male who presented with nine episodes of SM and PA over eight years. Serial neuroimaging studies including brain magnetic resonance imaging (MRI), blood flow single photon emission tomography (SPECT),(18) F-fluorodeoxyglucose positron emission tomography (FDG-PET) and(11) C-flumazenil PET (FMZ-PET) demonstrated cerebral vasogenic edema (CVE) with hypoperfusion and hypometabolism in the area, anatomically corresponding to the area with PA. SM and PA were effectively controlled by corticosteroid therapy. Follow-up MRI revealed complete reversibility of the CVE, which was supported by normal FMZ-PET and FDG-PET findings.
We have described a patient with transient brain lesions associated with complications of migraine who was diagnosed with fully reversible and steroid responsive CVE.
偏头痛状态（SM）和无梗死的持续性先兆（PA）是偏头痛的并发症。尽管已有数例患者被报道存在与偏头痛并发症相关的可逆性脑病变，但其性质和病理生理学仍不清楚。
我们报告一名38岁男性，在八年中出现了9次SM和PA发作。包括脑磁共振成像（MRI）、血流单光子发射计算机断层扫描（SPECT）、（18）F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和（11）C-氟马西尼PET（FMZ-PET）在内的系列神经影像学研究显示，在解剖学上与PA区域相对应的区域出现了脑血管源性水肿（CVE），伴有灌注不足和代谢减低。SM和PA通过皮质类固醇治疗得到有效控制。随访MRI显示CVE完全可逆，FMZ-PET和FDG-PET的正常结果也证实了这一点。
我们描述了一名与偏头痛并发症相关的短暂性脑病变患者，该患者被诊断为完全可逆且对类固醇有反应的CVE。
