偏头痛常可伴有神经功能缺失,多数学者认为,应将这些神经机能障碍归因于缺血性脑卒中,推测是继发血管痉挛所致。作者报告3例女性患者,在偏头痛期间或偏头痛发作即刻同时有脑叶出血。例1,61岁,有典型偏头痛史4年,发作时有左侧感觉异常。本次因与既往相似的双颞部严重疼痛,而急诊。初次检查发现血压正常,其他检查均无异常,腰穿为正常脑脊液。2天后再次发生严重头痛,伴有中度左偏瘫和左侧巴氏征阳性,血压正常。头颅CT平扫及增强均正常。24小时后,头痛加剧。有高血压、心动徐缓、意识恍惚、左偏瘫、左同向偏盲及眼球向右凝视。CT扫描证实为右额顶部脑内出血。颈动脉造影示右中动脉起始段狭窄,但无动静脉畸形、动脉瘤或肿瘤的证象。右侧额顶部开颅术清除血肿,病理检查为脑组织坏死,周围部分小动脉坏死性破裂,而无血管畸形、肿瘤或动脉淀粉样变性的证据。例2,45岁,患普通型偏头痛多年,发作时伴有畏光和恶心。入院前一天发生与平常相似,而程度稍重的头痛。24小时后,突发左侧轻瘫,左侧偏身感觉障碍。入院时血压,心率正常。右侧颈动脉触痛,但搏动正常,无杂音。CT扫描示右额顶 Migraine often accompanied by neurological deficits, most scholars believe that these neurological dysfunction should be attributed to ischemic stroke, presumably caused by secondary vasospasm. The authors report three women who had lobar hemorrhage either immediately or during a migraine attack. Example 1, 61 years old, with a history of typical migraine 4 years, the onset of left sensory abnormalities. This time due to previous similar double-temporal severe pain, and emergency. Initial examination revealed normal blood pressure, other tests were normal, lumbar puncture is normal cerebrospinal fluid. Severe headache again after 2 days, accompanied by moderate left hemiplegia and left Papillary sign positive, normal blood pressure. CT scan and enhancement of the skull were normal. After 24 hours, headache intensified. Hypertension, bradycardia, trance, left hemiplegia, with the left hemianopia and eye gaze to the right. CT scan confirmed the top right forehead brain hemorrhage. Carotid angiography showed the beginning of the right middle artery stenosis, but no evidence of arteriovenous malformations, aneurysms or tumors. The top right craniotomy removed the hematoma. The pathological examination was necrosis of the brain tissue and necrosis of the surrounding arterioles without evidence of vascular malformation, tumor or arterial amyloidosis. Example 2,45 years old suffering from ordinary migraine for many years, with photophobia and nausea. One day before admission, a headache similar to usual but a little heavier. Twenty-four hours later, the sudden left paralysis, left side of the sensory dysfunction. Admission of blood pressure, heart rate normal. Right carotid artery tenderness, but normal beats, no noise. CT scan shows the right forehead