产后头痛诊断为可逆性脑血管收缩综合征1例  

Reversible cerebral vasoconstriction syndrome characterized by postpartum headache: a case report

作　　者：张晓雯 周颖[1] 张丽娜[2] 石芳鑫[1] Zhang Xiaowen;Zhou Ying;Zhang Lina;Shi Fangxin(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,China;Department of Imaging,the First Affiliated Hospital of Dalian Medical University,Dalian 116000,China)

机构地区：[1]大连医科大学附属第一医院妇产科,大连116000 [2]大连医科大学附属第一医院影像科,大连116000

出　　处：《中华围产医学杂志》2022年第3期215-217,共3页Chinese Journal of Perinatal Medicine

摘　　要：本文报告了1例产后发生雷击样头痛, 诊断为可逆性脑血管收缩综合征患者的诊治经过。患者产后第2天出现雷击样头痛, 渐加剧, 产后第4天突发抽搐伴高血压, 考虑为"产后子痫", 于2020年5月19日收入院。入院后完善颅脑磁共振血管成像等检查, 经神经内科会诊, 明确诊断为可逆性脑血管收缩综合征。经治疗, 患者血压降至正常, 产后50余日影像学检查显示脑血管痉挛缓解。患者出院后随访至2021年6月, 再未发生头痛或抽搐。We report the diagnosis and treatment of a case of reversible cerebral vasoconstriction syndrome characterized by postpartum thunderclap headache.The patient experienced a thunderclap headache on the second day after delivery,which gradually worsened.On postpartum day 4,she presented with sudden convulsion and hypertension on admission on May 19,2020,and was initially diagnosed with postpartum eclampsia.We confirmed the diagnosis of reversible cerebral vasoconstriction syndrome based on the results of cranial magnetic resonance angiography(MRA)and other examinations and the consultation with neurologists.After antihypertensive and spasmolytic treatment,the patient's blood pressure returned to normal,and she was discharged on postpartum day 8.Reexamination with cranial MRA at 50^(+) days after delivery indicated that the cerebral vasospasm was relieved.No severe headaches or convulsions were observed during follow-up till June 2021.

关 键 词：头痛症 原发性 血管痉挛 颅内 产褥期疾病 高血压 

分 类 号：R714.6[医药卫生—妇产科学]