Morimoto Y, Nakajima S, Nishioka R, Nakamura H
Rinsho Shinkeigaku. 1993 Jan;33(1):61-7.
We report a case of basilar artery migraine with transient MRI and EEG abnormalities. A 25-year-old male medical student developed a right occipital throbbing headache one hour after the abrupt onset of vertigo, nausea, left-sided homonymous hemianopsia and nystagmus. All of his complaints subsided the following day. He had suffered from attacks of headache accompanied by the same type of aural symptoms almost every ten days. He was therefore diagnosed as having basilar artery migraine. CT scans during the period of recurrent migraine demonstrated no abnormalities, while T2-weighted MR images revealed a high signal intensity region in the right occipital cortex and adjacent white matter perfused by rami temporales of the right posterior cerebral artery. Cerebral hypoperfusion was detected by a SPECT scanner in the right posterior region, where EEG recorded during the migraine attack demonstrated paroxysmal-localized sharp waves. MRI and EEG performed two months after the last attack showed no obvious abnormalities along with clinical disappearance of the migraine attacks. We found few reports of transient MRI changes associated with migraine. This case suggests that transient changes in MR images reflect vasogenic edema caused by migraine.
我们报告一例伴有短暂性MRI和脑电图异常的基底动脉型偏头痛病例。一名25岁的男性医学生在突然出现眩晕、恶心、左侧同向性偏盲和眼球震颤1小时后，出现右侧枕部搏动性头痛。第二天他所有的不适症状都消失了。他几乎每十天就会发作一次伴有相同类型耳部症状的头痛。因此，他被诊断为基底动脉型偏头痛。复发性偏头痛发作期间的CT扫描未显示异常，而T2加权MR图像显示右侧枕叶皮质及相邻白质有一个高信号强度区域，由右侧大脑后动脉颞支供血。SPECT扫描仪在右侧后部区域检测到脑灌注不足，偏头痛发作时在此处记录的脑电图显示阵发性局灶性尖波。最后一次发作两个月后进行的MRI和脑电图检查显示无明显异常，偏头痛发作的临床症状也消失了。我们发现很少有关于偏头痛相关的短暂性MRI改变的报道。该病例表明，MR图像的短暂性改变反映了偏头痛引起的血管源性水肿。
