Abstract:
Headache and neurological deficits with cerebrospinal fluid (CSF) lymphocytosis (HaNDL) is a rare condition characterised by recurrent episodes of headache and transient neurological deficits. This case report presents a young patient initially diagnosed with hemiplegic migraine, having a normal brain CT, with focal cerebral perfusion mismatch not restricted to a single vascular territory on CT angiography. Brain MRI revealed a cytotoxic lesion of the splenium in the corpus callosum (CLOCC), a feature also reported in migraine. However, recurrent headaches with neurological deficits prompted further investigations with CSF analysis and brain MRI, confirming HaNDL and demonstrating reversibility of CLOCC. Recognising HaNDL as a differential diagnosis is essential in patients with recurrent headaches with focal neurological deficits, given the differences in therapeutic approach. The relationship between migraine and HaNDL is not fully understood, but they may share a pathophysiological link. Awareness of this is crucial for accurate diagnosis.
摘要:
伴有脑脊液(CSF)淋巴细胞增多(HaNDL)的头痛和神经功能缺损是一种罕见的疾病,其特征是头痛和短暂性神经功能缺损的反复发作。该病例报告介绍了一名最初被诊断为偏瘫偏头痛的年轻患者,有正常的脑部CT,局灶性脑灌注不匹配,不仅限于CT血管造影的单个血管区域。脑部MRI显示call体(CLOCC)中的脾细胞毒性病变,偏头痛也有报道。然而,伴有神经功能缺损的复发性头痛促使进一步的脑脊液分析和脑MRI研究,确认HaNDL并证明CLOCC的可逆性。认识到HaNDL作为鉴别诊断对于伴有局灶性神经功能缺损的复发性头痛患者至关重要。鉴于治疗方法的差异。偏头痛与HaNDL之间的关系尚未完全了解,但他们可能有共同的病理生理联系.意识到这一点对于准确诊断至关重要。