偏头痛性脑白质病变

Migrainous Leukoencephalopathy

目的 :探讨偏头痛性脑白质病变的病因及发病机制。方法 :回顾性分析 2 9例头颅 MRI证实有皮质下脑白质病变的偏头痛患者的临床资料。结果 :偏头痛 2 9例中 8例 ( 2 7.6 % )有家族性头痛史 ,2 5例 ( 86 .2 % ) TCD检查有脑血流速度增加或降低 ,其中以脑血流速度下降为主 ,占 5 1.7% ,头颅 MRI2 9例中 2 8例 ( 96 .6 % )有皮质下脑白质多灶性小圆点状长 T1 长 T2 改变 ,其中 11例 ( 39.3% )有两侧对称性特点 ,1例基底节 MRI示小点状长 T1 长 T2 改变。 1例皮肤活检电镜示血管平滑肌内有嗜锇酸颗粒沉积。结论 :偏头痛与遗传因素及免疫反应有关 。

Objective:To explore the etiology and pathogenesis of the migrainous leukoencephalopathy.Methods:The clinical data of 29 migraine cases with abnormalities of white matter of brain confirmed by MRI were analyzed retrospectively.Results:8 of 29 cases had family history, cerebral blood increasing and reducing confirmed by TCD in 25 cases, Moreover, there were long T 1 and long T 2 changes in white matter in 28 of 29 cases. Abnormalities were found symmetry in both cerebral hemisphere of 11 of 29 cases. The remaining 1 case had long T 1 and long T 2 changes of cases in both basal ganlions. Skin biopsy was performed in 1 case and granular osmophilic materials(GOM) were found in vessel smooth muscle cells by electron microscopy.Conclusion:Migraine had relation with hereditary factor and immune respone, some migraine with subcortical leukoencephal opathy could be one of heredofamilial cerebral vascular diseases.