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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Horner's Syndrome and Thunderclap Headache
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Horner's Syndrome and Thunderclap Headache

机译：角振子的综合症和霹雳头痛

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摘要

A 50-year-old woman presented to urgent care 2 days after an acute-onset holocephalic thunderclap headache while dining. Her past medical history was significant for ibuprofen-responsive unilateral episodic migraine headaches (4 times a month), fibro-myalgia, and depression. Her medications included gabapentin and duloxetine. Her headache reached maximal intensity within seconds associated with nausea and photophobia. Neurological examination was reported as normal without meningismus. She was treated with intravenous ketorolac for presumed status migrainosus. She had symptom relief for 2 days, but the thunderclap headache returned unrelieved by ibuprofen use. She presented to the emergency room, and neurological examination was again reported as normal. Computed tomography head and neck angiogram (CTA) was reported as unremarkable with no aneurysm or subarachnoid hemorrhage. Cerebrospinal fluid profile was within normal limits. She was treated with intravenous ketorolac, diphenhydramine, and magnesium. A diagnosis of migraine was made, and she was referred to a local neurologist who prescribed sumatriptan and topiramate. She continued to suffer from recurrent thunderclap headaches with fluctuating intensity and no response to treatment.
机译：一名50岁的女性在吃饭时出现急性全脑雷霆头痛2天后接受了紧急护理。她过去的病史对布洛芬敏感的单侧发作性偏头痛（每月4次）、纤维肌痛和抑郁症有重要意义。她的药物包括加巴喷丁和度洛西汀。她的头痛在几秒钟内达到最大程度，伴有恶心和畏光。神经系统检查报告为正常，无脑膜炎。她接受静脉注射酮咯酸治疗，以推测偏头痛状态。她症状缓解了两天，但雷霆般的头痛并没有因使用布洛芬而得到缓解。她被送往急诊室，神经系统检查再次报告为正常。计算机断层扫描头颈部血管造影（CTA）报告为无动脉瘤或蛛网膜下腔出血。脑脊液剖面在正常范围内。她接受了静脉注射酮咯酸、苯海拉明和镁的治疗。诊断为偏头痛，她被转诊给当地的神经科医生，医生给她开了舒马曲普坦和托吡酯。她继续患有反复发作的霹雳头痛，头痛强度波动，治疗无效。

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