AURU可能的MIGRENE的临床影响,

Олена Сергіївна Нікіфорова, О.В. Саник, М Ю Дельва
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引用次数: 0

摘要

我们提出一个临床病例缺血性中风在一个男人与新发偏头痛发作。临床病例。男,25岁,左颞区剧烈搏动性头痛,呕吐,右侧视力受损,右腿麻木,入院急性脑血管科。症状以右视野暗斑的形式突然出现。20分钟后,出现剧烈的抽动性头痛、恶心和右腿麻木。在此之前,他们被剥夺了2天的睡眠。病人的母亲有先兆偏头痛。在此之前,该患者从未有过这样的症状。检查结果:右侧同侧上象限偏盲,右腿感觉减退。脑MRI -左枕区T2和DWI局灶性高信号(急性缺血性脑卒中)。患者第一天服用阿司匹林300毫克,然后每天服用100毫克,然后每天服用丙戊酸1200毫克。住院2天后,患者右腿敏感恢复,右侧同侧上象限偏盲退化为小暗斑。患者于第5天出院,右侧小暗斑。建议继续服用阿司匹林100毫克/天,丙戊酸1200毫克/天,二级预防偏头痛发作和中风。讨论。本病例的特点包括:无偏头痛病史(至少5次或以上偏头痛发作),重度偏头痛发作伴长时间先兆症状,由睡眠剥夺引发,最终发展为缺血性中风。结论。有必要考虑缺血性中风的可能性,即使在新发偏头痛发作的情况下。如果偏头痛先兆持续时间超过60分钟,有必要进行脑MRI检查,以发现脑缺血的早期迹象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
КЛІНІЧНИЙ ВИПАДОК МОЖЛИВОЇ МІГРЕНІ З АУРОЮ, УСКЛАДНЕНОЇ МІГРЕНОЗНИМ ІНФАРКТОМ
We present a clinical case of ischemic stroke in a man with a new-onset migraine attack. Clinical case. A 25-year-old man was admitted to the acute cerebrovascular department due to severe throbbing headache in the left temporal area, vomiting, impaired vision on the right and numbness of the right leg. Complaints appeared abruptly in the form of scotoma in the right visual field. 20 minutes later, severe throbbing headache, nausea and numbness of the right leg developed. The event was preceded by sleep deprivation for 2 days. The patient’s mother has migraine with aura. Previously, the patient never had such attacks. On examination: right-sided homonymous upper-quadrant hemianopsia, hypoesthesia of the right leg. Brain MRI - focal hyperintensity at T2 and DWI in the left occipital region (acute ischemic stroke). The patient took aspirin at a dose of 300 mg for the first day, then 100 mg per day and valproic acid at a dose of 1200 mg per day. Two days after hospitalization, the patient experienced recovery of sensitivity in the right leg and regression of right-sided homonymous upper quadrant hemianopsia to small scotoma. The patient was discharged on the 5th day with a small right scotoma. It is recommended to continue taking aspirin 100 mg/day and valproic acid 1200 mg/day for the secondary prevention of migraine attacks and stroke. Discussion. The peculiarities of this case include the lack of history of migraine (at least 5 or more migrainous headache attacks) and the development of severe migraine attack with prolonged aura symptoms, which was triggered by sleep deprivation and eventually evolved into ischemic stroke. Conclusions. It is necessary to consider the possibility of ischemic stroke even in the cases of a new-onset migraine attack. If migrainous aura duration exceeds 60 minutes, it is necessary to perform a brain MRI to detect the early signs of cerebral ischemia.
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