Not just any headache

IF 5.1 2区 医学 Q1 OPHTHALMOLOGY Survey of ophthalmology Pub Date : 2024-03-01 DOI:10.1016/j.survophthal.2023.10.009
Janet Fan BA , Pamela Davila MD , Noor Laylani MD , Andrew G. Lee MD , Benjamin Frishberg MD, FAAN
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Abstract

A 40-year-old man with a history of traumatic retinal detachment in the left eye treated with scleral buckle and migraine with aura presented to clinic for persistent blurry vision of the right eye following an episode of migraine with aura. The patient had experienced migraines with visual auras starting as a teenager, which normally resolve within an hour except for the most recent episode. Humphrey visual field showed a right superior homonymous quadrantanopia. Computed tomography of the head without contrast showed acute ischemia in the left occipital lobe. Magnetic resonance imaging of the brain confirmed an ischemic infarct of the left occipital lobe. There were no significant abnormalities in complete blood count, metabolic panel, coagulation studies, and infectious testing. Echocardiogram and transthoracic echocardiography were normal as well, but further work up by cardiology revealed a patent foramen ovale on transesophageal echocardiogram. This case illustrates a rare case of migrainous infarction, which should be considered as a possible complication of migraine with aura, presenting with persistent visual changes.

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不是一般的头痛
一名 40 岁的男性患者曾因左眼外伤性视网膜脱落接受过巩膜扣带治疗,并患有先兆偏头痛,在一次先兆偏头痛发作后因右眼视力持续模糊而就诊。患者从十几岁开始就有偏头痛伴先兆视力模糊的症状,除了最近一次发作外,通常在一小时内缓解。Humphrey 视野显示右上同位象限视。头部无造影剂计算机断层扫描显示左枕叶急性缺血。脑磁共振成像证实左枕叶缺血性梗塞。全血细胞计数、新陈代谢检查、凝血检查和传染病检测均无明显异常。超声心动图和经胸超声心动图也正常,但心脏科的进一步检查发现,经食道超声心动图有一个卵圆孔未闭。本病例是一个罕见的偏头痛脑梗塞病例,应将其视为有先兆偏头痛的可能并发症,表现为持续性视觉变化。
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来源期刊
Survey of ophthalmology
Survey of ophthalmology 医学-眼科学
CiteScore
10.30
自引率
2.00%
发文量
138
审稿时长
14.8 weeks
期刊介绍: Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts.
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