Walser H, Isler H, Hess R
Schweiz Med Wochenschr. 1979 Mar 31;109(13):472-7.
A 49-year-old woman subject to frequent migraine attacks since childhood was seen for repeated episodes of confusion followed by loss of consciousness lasting for several hours. EEG during the acute stages showed marked slowing with bifrontal monorhythmic delta waves. After each episode, both the clinical and EEG findings subsided within hours. A similar course is described in a man who died at the age of 69 after preterminal mental deterioration. Autopsy showed evidence of bilateral damage to the hippocampal regions, apparently due to frequent impairment of perfusion in the last years of life. Atherosclerotic changes were within the normal range for his age. In both cases, the ischemic episodes are interpreted as consequences of constriction of the basilar artery, and it is assumed that the underlying mechanism is at least akin to that of migraine.
一名49岁女性自幼频繁发作偏头痛,现因反复出现意识模糊,随后昏迷数小时前来就诊。急性期脑电图显示明显减慢,伴有双额单节律δ波。每次发作后,临床症状和脑电图表现均在数小时内消退。一名69岁男性在临终前精神衰退后死亡,其病程与此相似。尸检显示双侧海马区有损伤迹象,显然是由于生命最后几年频繁出现灌注受损所致。动脉粥样硬化改变在其年龄的正常范围内。在这两个病例中,缺血性发作被解释为基底动脉收缩的后果,并且推测其潜在机制至少与偏头痛的机制相似。