缘于未破裂颅内囊状动脉瘤的头痛研究进展

Progress of Headache Attributed to Unruptured Intracranial Saccular Aneurysm

颅内囊状动脉瘤破裂是自发性蛛网膜下腔出血最主要的原因。早期识别缘于未破裂颅内囊状动脉瘤的头痛,对预防出血性事件的发生有重要临床意义。缘于未破裂颅内囊状动脉瘤的头痛机制仍不清楚,目前认为与动脉瘤本身形成的扩张、压迫、血管壁剥离、动脉搏动以及微出血有关,炎症机制参与其中。缘于未破裂颅内囊状动脉瘤的头痛并无特异性特征,以偏头痛样头痛为主,新发的、剧烈的、持续的以及性质变化频繁的头痛需警惕动脉瘤破裂可能,SWI有助于早期识别高危头痛。缘于未破裂囊状动脉瘤的头痛治疗更倾向于简单的盘绕术,但仍需大样本研究观察。

Rupture of intracranial saccular aneurysm is the main cause of spontaneous subarachnoid hemorrhage(SAH).Recognizing the characteristics of headache due to the unruptured intracranial saccular aneurysm(UISA)is of important clinical value to prevent the occurrence of hemorrhagic events.The mechanism of headache due to UISA is still unclear,which is now believed to be related to the dilation,compression of aneurysm,stripping of vessel wall,artery pulsation and microbleeding.And inflammatory is also involved in the process.The characteristics of headache are not specific,and migraine-like headache is the main type.For new-onset,severe,persistent headache,and headache nature changing frequently,it should be alert to the possibility of aneurysm rupture.SWI is helpful to identify high-risk headache.Simple coiling is preferred for treatment of headache due to UISA,but large sample studies are still needed.