筋収縮性頭痛として経過観察中に情動ストレス下で起きたクモ膜下出血の1例

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We reported a patient of subarachnoid hemorrhage who had been hospitalized to treat a psychosomatic disorder. The case was a 34-year-old woman who had suffered from chronic recurrent headaches since her infancy. Her illicit love affair with a married man, who had his own family, was discovered in June, 1988. Since that time, she had complained of insomnia and headaches. Her headaches worsened on August 7,when she visited hospital. She strongly desired to be admitted to the hospital and was brought to our hospital by ambulance. On admission, She showed neither any neurological deficits, nor intracranial lesions after a head CT. We tried to relieve her from anxiety by explaining the mechanisms of muscle contraction headaches, prescribing minor tranquilizers, and introducing autogenic training into her treatment. Although she reported to us an improvement in the symptoms by relaxation, she later suffered a subarachnoid hemorrhage on September 12 when she was confronted with the fact that the man's wife was still very angry at her. She died on September 15,and the bereaved family did not allow an autopsy. We have discussed the following points regarding this case : 1) This case was considered to have had headaches which appeared to be muscle contraction headaches which were closely related to her psychosocial background. 2) Her hypertension was considered to have derived from the emotional strain caused by inappropriate social behavior such as getting divorced of her own will, having an illicit affair with a married man and then trying to commit suicide. 3) Concerning the subarachnoid hemorrhage, we suspected that she had an aneurysm of the right anterior communicating artery, which ruptured due to an elevation of blood pressure brought on by the emotional turmoil.
日本心身医学会の論文
1992-08-01

筋収縮性頭痛として経過観察中に情動ストレス下で起きたクモ膜下出血の1例

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