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We have already emphasized the intimate correlation between migrainous attacks and intracranial vascular abnormality. The purpose of this paper is to report clinical character-istics of migrainous patients who showed angiographically intracranial vascular abnormali-ties as second report successively.Case 1: A 64-years-old female had the only occipital throbbing headache with the visual or auditory auras from five years ago.Bilateral carotid and vertebral angiography showed an obviously poor filling of the right posterior cerebral artery at every trials.Case 2: A 28-years-old male had had repeated attacks of migraine after few minutes of scintillating scotoma. On admission he had no neurological deficit. The contrast en-hanced CT scan revealed a paraventricular high density area at the left trigon. Left carotid angiography demonstrated the small angioma at the region above stated, which was fed from the left posterior cerebral artery via the left posterior communicating artery.Case 3 : A 29-years-old female had had mainly right migraine attacks since age of nineteen-years-old. Since 24-years-old of first delivery, the patient has developed migraine with scintillating scotoma as an aura. There were no neurological abnormality, but E. E. G. showed slow wave burst in the bilateral fronto-parietal region by hyperventilation. A large arterio-venous malformation was recognized in the right occipital region, fed by the anterior-, middle- and mainly posterior cerebral artery on the right side.After the total removal of this AVM, migraine attacks disappeared.Case 4: A 48-years-old female complained vertigo and fainting spells since age of 32-years-old. The patient had had migrainous attacks associated with the aura of left homo-nymous visual narrowing. On admission she had no neurologioal deficits. The E.E.G. examination showed 6-7 c/s theta wave burst in all lead, built up by hyperventilation.Right carotid and vertebral angiography demonstrated the giant gobang-like arterio-venous aneurysms in the posterior infracallosal and Galen's region. This aneurysms were fed by two abnormal vessels from the right posterior cerebral artery.The authors speculated that the abnormal filling of unilateral posterior cerebral artery and posterior communicating artery (vertebro-basilar system) might cause a circulatory instability of the diencephalon and upper brainstem. Therefore, such a instability of these region might be easy to induce the neuronal or humoral trigger of migrainous attack. Angiographic finding in these four cases lead us to consider that there may be an intimate correlation between migrainous attack and intracranial vascular abnormality in some patients.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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