在过去的几十年中,偏头痛的患病率有所上升,这可能归因于生活方式的改变。鼻出血在偏头痛中不常见。这里我们介绍了四个病人的病例系列,出现与鼻出血相关的头痛。根据国际头痛协会,详细的病史揭示了偏头痛的主要症状,包括持续4至72小时的中度至重度强度的半颅搏动性头痛,以及相关的恶心特征,呕吐,畏光,和恐惧症。调查,包括ENT(耳朵,鼻子,和喉咙)检查,鼻内窥镜检查,胃镜检查,支气管镜检查,血液学,和凝血参数,是阴性的。所有患者开始预防性治疗偏头痛,他们反应很好。鼻出血发生在头痛的高峰期,随后症状趋于缓解。这背后的病理生理学是刺激三叉神经血管系统,导致颈外动脉和颈内动脉扩张。
Migraine prevalence has risen over the last few decades, which may be attributed to lifestyle changes.
Epistaxis is unusual in migraine. Here we present a case series of four patients, who are presented with headaches associated with
epistaxis. A detailed history revealed cardinal symptoms of migraine according to the International Headache Society, including hemicranial throbbing headache of moderate to severe intensity lasting for a duration of four to 72 hours, along with associated features of nausea, vomiting, photophobia, and phonophobia. Investigations, including ENT (ear, nose, and throat) examination, nasal endoscopy, gastroscopy, bronchoscopy, hematological, and coagulation parameters, were negative. All patients were started on prophylactic treatment for migraine, and they responded well.
Epistaxis occurs at the peak of headache following which symptoms tend to resolve. The pathophysiology behind this is stimulation of the trigeminovascular system leading to dilatation of external and internal carotid arteries.