健康卡车司机脑出血的罕见病因。

Sankalp Gokhale, Shivani Ghoshal, Sourabh Lahoti, Louis R Caplan, Louis R Caplan
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引用次数: 5

摘要

目的:报告一例偏头痛引起的脑出血并复习文献。设计:病例报告。地点:马萨诸塞州波士顿哈佛医学院贝斯以色列女执事医疗中心。患者:54岁卡车司机,2年非典型头痛病史。结果:一位54岁的右撇子卡车司机就诊,有2年的非典型头痛病史。头痛沉闷,悸动,逐渐进行性,局限于左枕区。患者伴有右视野缺损、复视,有时还会出现思维混乱。这些头痛与他20多年来一直患有的常见偏头痛明显不同。脑成像显示左侧顶枕叶出血。进一步的调查排除了动静脉畸形。他没有任何血管危险因素,包括高血压。偏头痛相关的脑出血被认为是最有可能的诊断。结论:偏头痛脑出血可能是由于血管收缩导致血管壁缺血,使其渗漏和多孔所致。意识到这一现象是很重要的,因为用于治疗偏头痛的血管活性药物会进一步加剧血管收缩,从而导致脑出血。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An uncommon cause of intracerebral hemorrhage in a healthy truck driver.

Objectives: To describe a case and review literature for intracerebral hemorrhage caused by migraine.

Design: Case report.

Setting: Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Patient: A 54-year-old truck driver with a 2-year history of atypical headaches.

Results: A 54-year-old right-handed truck driver was seen in consultation with a 2-year history of atypical headaches.The headaches were dull, throbbing, gradually progressive,and limited over the left occipital area. They were accompanied by right visual field deficit, diplopia, and,at times, confusion. These headaches were notably different from the usual migraine headaches he had been having for more than 20 years. Brain imaging revealed left parieto-occipital lobar hemorrhage. Further investigations ruled out arteriovenous malformations. He did not have any vascular risk factors, including hypertension. Migraine-associated intracerebral hemorrhage was considered to be the most likely diagnosis.

Conclusions: Intracerebral hemorrhage associated with migraine is believed to result from vasoconstriction leading to ischemia of the walls of blood vessels, making them leaky and porous. It is important to be aware of this phenomenon because vasoactive medications used to treat migraine can further aggravate the vasoconstriction and hence the intracerebral bleed.

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Archives of neurology
Archives of neurology 医学-临床神经学
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