Nighoghossian N, Derex L, Trouillas P
Centre de Recherches sur I'Ataxie, Hôpital Neurologique, Lyon, France.
Headache. 1998 Jun;38(6):478-80. doi: 10.1046/j.1526-4610.1998.3806478.x.
The occurrence of intracerebral hemorrhage during an acute attack of migraine remains questionable. A normotensive migrainous woman experienced multiple intracerebral hemorrhages. No drug abuse was recorded, but bleeding occurred after the use of several antimigrainous drugs. Angiography revealed severe vasospasm of both anterior cerebral arteries. Subsequent brain MRI and MRI angiography failed to show any vascular abnormalities. Echocardiography and an exhaustive biological evaluation ruled out an alternative condition favoring intracerebral hemorrhage. Multiple intracerebral hemorrhages in migraine may exceptionally be related to vasospasm leading to arterial wall injury. Intracranial arterial vasospasm could be precipitated by excessive vasoactive therapy.
偏头痛急性发作时发生脑出血的情况仍存在疑问。一名血压正常的偏头痛女性经历了多次脑出血。未记录到药物滥用情况，但在使用几种抗偏头痛药物后出现了出血。血管造影显示双侧大脑前动脉严重血管痉挛。随后的脑部MRI和MRI血管造影未显示任何血管异常。超声心动图和详尽的生物学评估排除了导致脑出血的其他情况。偏头痛中的多次脑出血可能异常地与导致动脉壁损伤的血管痉挛有关。过度的血管活性治疗可能引发颅内动脉血管痉挛。
