烟雾病及其所引发头痛的研究进展

Recent advance in Moyamoya angiopathy and its related headache

烟雾病是一种慢性进行性颅内血管病变,其辅助检查方法包括CT血管造影、MRI、数字减影血管造影等。头痛是烟雾病患者常见的症状,烟雾病所引发的头痛表型以偏头痛样表现与紧张型头痛为主,其机制涉及颅内外动脉及柔脑膜侧支的扩张、脑灌注不足、血管内皮损伤、遗传易感性及精神压力等多个方面,治疗包括外科血管重建术及药物治疗等策略。本文现重点围绕该类型头痛的临床表现、发病机制、诊治及预后进行综述,以期加深临床工作者对该症状的了解。

Moyamoya angiopathy is a chronic progressive occlusive intracranial vasculopathy,and CT angiography,MRI,digital subtraction angiography are the auxiliary examinations.Headache is a common symptom in Moyamoya angiopathy(MMA)patients,and the phenotypes of headache attributed to MMA mainly include migraine-like headache and tension type-like headache;mechanism involves in dilatation of intracranial and extracranial arteries and leptomeningeal collaterals,cerebral hypoperfusion,vascular endothelial damage,genetic susceptibility,and mental stress.Strategies such as surgical revascularization and medical treatment are given.This article focuses on clinical manifestations,pathogenesis,diagnoses,treatments and prognoses of headache attributed to MMA,in order to deepen the understanding of clinical workers on this symptom.