Department of General Medicine, Geriatric Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886, Singapore.
Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
BMC Geriatr. 2020 Oct 7;20(1):392. doi: 10.1186/s12877-020-01768-5.
Paroxysmal hemicrania has not been associated with ipsilateral weakness, loss of sensation and Horner's syndrome. This report is the first of its kind documented in literature.
This was an elderly, sixty-five-year-old Chinese male who presented with a headache fulfilling criteria of paroxysmal hemicrania and was found to have signs of ipsilateral conjunctival injection, Horner's syndrome, weakness and loss of sensation; with resolution of the patient's physical signs after relief of the headache. Brain magnetic resonance imaging did not show any strokes or other headache mimics. The patient had a marked response to indomethacin and a decrease of headache intensity and frequency with indomethacin prophylaxis.
Paroxysmal hemicrania has joined the list of stroke chameleons and that it would be one of the differentials in a patient with hemiplegia, hemisensory loss, autonomic signs and severe headache. It suggests that paroxysmal hemicrania in the elderly present atypically.
丛集性头痛以前从未与同侧无力、感觉丧失和霍纳氏综合征有关。这是文献中首次记录到这种情况。
这是一名 65 岁的老年华人男性，头痛符合丛集性头痛的标准，并出现同侧结膜充血、霍纳氏综合征、无力和感觉丧失的体征；头痛缓解后，患者的体征也随之消失。脑部磁共振成像未显示任何中风或其他类似头痛的情况。患者对吲哚美辛有明显反应，吲哚美辛预防治疗可降低头痛强度和频率。
丛集性头痛已加入中风伪装者的行列，对于出现偏瘫、半感觉丧失、自主神经体征和严重头痛的患者，它是需要鉴别的疾病之一。这表明老年人的丛集性头痛表现不典型。
