Sanin L C, Mathew N T
Houston Headache Clinic, Texas 77004.
Cephalalgia. 1993 Aug;13(4):289-92. doi: 10.1046/j.1468-2982.1993.1304289.x.
We report on a 47-year-old white female with a long history of recurrent episodes of migraine with aura, who progressed to develop a continuous intractable headache during the course of which cortical blindness and quadriparesis occurred due to extensive and bilateral hemispheric cerebral infarction. Severe diffuse intracranial major arterial vasospasm was demonstrated by arteriogram. All studies were negative for CNS vasculitis, including cerebral biopsy. The arterial spasm reversed itself, but the patient did not improve. Smoking was the only additional risk factor. Vasospasm is an important cause to be considered in migrainous infarctions. The use of vasoconstrictor agents such as DHE in patients with migraine with prolonged aura has to be carefully re-evaluated.
我们报告了一名47岁的白人女性，她有长期反复发作的伴有先兆的偏头痛病史，病程中进展为持续性顽固性头痛，期间因广泛双侧半球脑梗死出现皮质盲和四肢瘫痪。血管造影显示严重弥漫性颅内主要动脉血管痉挛。所有检查包括脑活检均未发现中枢神经系统血管炎。动脉痉挛自行缓解，但患者病情未改善。吸烟是唯一的额外危险因素。血管痉挛是偏头痛性梗死中需考虑的重要病因。对于先兆持续时间较长的偏头痛患者，使用如二氢麦角胺等血管收缩剂必须谨慎重新评估。
