Martins I P, Baeta E, Paiva T, Campos J, Gomes L
Department of Neurology, Hospital de Santa Maria, Lisboa, Portugal.
Headache. 1993 May;33(5):227-33. doi: 10.1111/j.1526-4610.1993.hed3305227.x.
We report a series of 11 patients who developed headaches during intracranial endovascular procedures performed for the treatment of arteriovenous malformations (10 cases) or aneurysms (1 case). Headache was precipitated either by balloon inflation (3 cases) or by embolization (8 cases), and had a very constant pattern. In all cases the pain started suddenly, reaching maximum intensity at once. Headache was focal, unilateral, ipsilateral to the occluded artery, nonthrobbing and short-lasting (usually less than 10 minutes). It was not associated with gastrointestinal, autonomic, or aura-like symptoms. Headache localization depended upon the catheterized artery, being constant for each of the major vascular territories. Yet, in all patients pain was felt in the cutaneous territory of the ophthalmic division of the trigeminal nerve. The occurrence of headache was not associated with cortical deficit nor cortical irritation (assessed both clinically and by the EEG) and therefore seems to be directly related to the stimulation of the arterial wall. This type of pain can be used as a model of pure vascular headache. Its study can contribute not only to understand the pattern of intracranial vascular innervation but also to understand or to refute the vascular components of migraine.
我们报告了一组11例患者，他们在接受颅内血管内手术治疗动静脉畸形（10例）或动脉瘤（1例）期间出现头痛。头痛由球囊充盈（3例）或栓塞（8例）诱发，且具有非常固定的模式。在所有病例中，疼痛突然发作，立即达到最大强度。头痛为局限性、单侧性，与闭塞动脉同侧，非搏动性且持续时间短（通常少于10分钟）。它与胃肠道、自主神经或先兆样症状无关。头痛的定位取决于导管插入的动脉，在每个主要血管区域都是固定的。然而，所有患者均在三叉神经眼支的皮肤区域感到疼痛。头痛的发生与皮质功能缺损或皮质刺激无关（通过临床和脑电图评估），因此似乎与动脉壁的刺激直接相关。这种类型的疼痛可作为单纯血管性头痛的模型。对其研究不仅有助于了解颅内血管神经支配模式，还有助于理解或反驳偏头痛的血管成分。
