【頭痛のみを呈する小児もやもや病の管理】
頭痛のみを呈していて血管病変も軽度のもやもや病のお子さんをどのように管理すべきか？現在も治療指針が確立されていないのが現状です。
今回、われわれは、このようなお子さんの中には急速に血管病変が進行して脳梗塞をきたす症例が存在することを報告するとともに、今後の管理指針について提言させていただきましたので、ぜひご一読下さい。
Vuignier S, Akioka N, Hamada H, Kashiwazaki D, Kuroda S.
Childs Nerv Syst. 2014 Apr 1. [Epub ahead of print]
Headache attack followed by rapid disease progression in pediatric moyamoya disease-how should we manage it?
http://0-www.ncbi.nlm.nih.gov.elis.tmu.edu.tw/pubm…/24687592
CASE REPORT:
A 4-year-old female was presented at our hospital with frequent right frontal headache attack. She was diagnosed with moyamoya disease and was conservatively followed up. One year later, the frequency of headache gradually decreased. However, follow-up MR imaging revealed that the disease stage markedly progressed in the right side and cerebral infarction occurred in the temporal lobe with atrophy of the right frontal lobe. She underwent direct and indirect revascularization on the right side.
CONCLUSION:
Aware of this case, we would like to emphasize that headache may be one subtype of ischemic attacks and require frequent MR follow-up to see the disease course. If there is any sign of disease progression, immediate surgical intervention should be indicated to avoid irreversible brain damage.
