Sjaastad O, Stovner L J, Stolt-Nielsen A, Antonaci F, Fredriksen T A
Department of Neurology, Regionsykehuset i Trondheim, Trondheim University Hospitals, Norway.
Headache. 1995 Jun;35(6):363-7. doi: 10.1111/j.1526-4610.1995.hed3506363.x.
Two female patients, one with chronic paroxysmal hemicrania and one with hemicrania continua, had a continuously high requirement of indomethacin, ie, > or = 225 mg per day, for 4 and 7 years, respectively. In the hemicrania continua patient, a right (symptomatic side) C7 root affection due to disc herniation was demonstrated. Removal of the disc relieved the arm pain completely, and reduced the head pain and indomethacin requirement considerably initially. The other patient suffered from the unremitting form of chronic paroxysmal hemicrania with right-sided attacks from the age of 16. Indomethacin, 200 to 250 mg per day generally kept the headache at bay, but during exacerbations, especially during menstrual periods, the dosage transitorily had to be increased to 250 to 350 mg per day. A CT scan with contrast at aged 18 (1987) was negative. In 1992, she started having new symptoms, including numbness on the ipsilateral side of the face and arm and difficulty swallowing. An MR scan showed a meningioma originating in the roof of the cavernous sinus on the symptomatic side. The meningioma was surgically removed. The postoperative indomethacin requirement was reduced, but only transiently. Patients with chronic paroxysmal hemicrania (CPH) and hemicrania continua (HC) with a continuously high indomethacin requirement may have grave additional disorders and should consequently be followed closely.
两名女性患者，一名患有慢性阵发性偏侧头痛，另一名患有持续性偏侧头痛，分别连续4年和7年对消炎痛有持续的高需求，即每天≥225毫克。在持续性偏侧头痛患者中，证实因椎间盘突出导致右侧（症状侧）C7神经根受累。摘除椎间盘后，手臂疼痛完全缓解，最初头痛和消炎痛需求也大幅降低。另一名患者自16岁起就患有持续型慢性阵发性偏侧头痛，右侧发作。每天服用200至250毫克消炎痛通常能控制头痛，但在病情加重时，尤其是在月经期，剂量不得不暂时增加到每天250至350毫克。1987年18岁时的增强CT扫描结果为阴性。1992年，她开始出现新症状，包括同侧面部和手臂麻木以及吞咽困难。磁共振扫描显示在症状侧海绵窦顶部有一个脑膜瘤。该脑膜瘤通过手术切除。术后消炎痛需求降低，但只是暂时的。对消炎痛有持续高需求的慢性阵发性偏侧头痛（CPH）和持续性偏侧头痛（HC）患者可能有严重的其他病症，因此应密切随访。
