房间隔缺损封堵术后新发偏头痛及偏头痛加重的临床分析  

Analysis of new-onset and exacerbated migraine after the closure of atrial septal defect

作　　者：唐澍[1] 孙葳[1] 邢海英[1] 马志刚[2] 李瑶[1] 胡洪涛[2] 黄一宁[1] 

机构地区：[1]北京大学第一医院神经内科,北京100034 [2]北京积水潭医院神经内科,北京100034

出　　处：《中风与神经疾病杂志》2015年第1期37-40,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的分析房间隔缺损封堵术后新发偏头痛及偏头痛加重患者的临床及相关检查特征。方法收集2011年9月~2014年5月间,房间隔缺损封堵术后新发偏头痛或已往偏头痛加重的患者,收集其临床资料,记录患者病史、体格检查结果。行经颅多普勒发泡试验、增强超声心动、影像学等检查,分析其临床及相关检查特征。结果共收集房间隔缺损封堵术后新发或原有症状加重的偏头痛患者4例。2例患者术后2 d内新发有先兆偏头痛。1例患者由术前无先兆偏头痛转为有先兆偏头痛。1例术前已诊断为有先兆偏头痛患者术后发作频率明显增加。4例患者术后行经颅多普勒发泡试验平静呼吸均未见右向左分流,Valsalva动作时3例均可见右向左分流,其中1例增强超声心动图可见右向左分流。3例患者行栓子监测均未见微栓子信号。4例患者影像学检查均未见异常。结论新发偏头痛或偏头痛加重可能是房间隔缺损封堵术的并发症,其原因可能与微栓塞关系不大。Objective To investigate the characters of clinic and examination in the patients with new-onset and exacerbated migraine after the closure of atrial septal defect（ ASD）. Methods Patients who came to our hospital between September 2011 to May 2014 with new-onset and exacerbation of migraine after closure of ASD were collected. The clinical data including history and physical examination were recorded. All the patients had transcranial doppler（ TCD） bubble test,contrast echocardiography and imaging test. The tests and clinical characters were analyzed. Result Four patients were collected. Two patients had new-onset migraine with aura（ MA） wihtin 2 days after the closure of ASD. One patient with diagnosis of migraine without aura（ MO） turned into MA. One patitent had increased attacks of MA. In the TCD bubble test,there was no right to left shunt during quietly breathing. Right to left shunts existed in 3 patients during valsalva maneuver and 1 of the 3 patients had right to left shunt in contrast echocardiography. Three patients had embolism monitoring test and none of them had microembolic signal. All of the patients had normal neuroimagings. Conclusion New-onset and exacerbation of migraine might be a complication of closure of ASD. Microembolization might not be the true reason.

关 键 词：房间隔缺损 偏头痛 经颅多普勒 

分 类 号：R747.2[医药卫生—神经病学与精神病学]