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偏头痛发作期出现的缺血性脑梗塞临床上少见,其发病机制尚未确知.偏头痛性缺血性脑梗塞最常见于大脑中动脉供应区,少数报道为单侧大脑后动脉(PCA)供应区梗塞,而双侧PCA梗塞迄今未见报告.本文介绍1例年轻偏头痛患者出现双侧PCA梗塞.患者,37岁男性.有偏头痛病史17年,每次头痛发作均有视物变形、暗点和近记忆障碍,持续数分钟至数小时后双额区出现轻到中度搏动性疼痛、怕光和不适等.每月发作1～2次,最近,发作频率增加.在近某次发作后记忆障碍和视力改变持续存在.颅脑CT扫描发现左侧颞-枕区梗塞,椎动脉造影显示左侧PCA闭塞,用阿斯匹林和潘生丁治疗.一周后患者再次出现视物变形,严重的近记忆障碍和弥漫的搏动性头痛.偏头痛家族史阳性.神经学检查发现顺行性记忆缺失,逆行性记忆中度减损;
The onset of migraine attacks in ischemic cerebral infarction is clinically rare, the pathogenesis has not yet been determined.Migra migraine ischemic infarction is most commonly found in the middle cerebral artery supply area, a small number reported as unilateral posterior cerebral artery (PCA) Supply of regional infarction, and bilateral PCA infarction so far no report.This article describes a case of young migraine patients with bilateral PCA infarction.Patients, 37-year-old male.Have a history of migraine for 17 years, each episode of headache have visual distortion , Dark spots and near memory disorders, sustained a few minutes to several hours after the double-volume area appear mild to moderate beating pain, fear of light and discomfort, etc. 1 to 2 times a month attack, the recent seizure frequency increased in the near Memory disorders and visual acuity persisted after the second episode.Cranial CT scan revealed left temporal-occipital infarction and vertebral artery angiography showed occlusion of the left PCA with aspirin and dipyridamole treatment. One week later, the patient again experienced visual distortion , Severe near-memory impairment and diffuse pulsatile headache. Positive family history of migraine. Neurological examination revealed a loss of congenital memory and a moderate impairment of retrograde memory;