A rare case of central post-stroke pain in a patient with migraine and lacunar infarcts in the medulla oblongata
Biomedicine (India)
; 43(1):243-246, 2023.
Article
in English
| EMBASE | ID: covidwho-2299483
ABSTRACT
Studies about headaches associated with acute ischemic stroke in patients suffering from migraine were limited, and therefore we present a clinical case of central post-stroke pain (CPSP) in a 47-year-old woman with migraine and lacunar infarcts in the medulla oblongata and also possible mechanisms of CPSP in patients with migraine. Magnetic resonance imaging of the brain revealed lacunar infarction in the medulla oblongata on the right (vertebral artery basin) and a single focus of gliosis in the parietal lobe on the right. Magnetic resonance angiography of cerebral vessels showed the fetal type of structure of both posterior cerebral arteries. This clinical case is a complex clinical situation of a combination of secondary headaches (post-stroke) in a patient with a primary headache (migraine), which was successfully treated by the combined administration of first-line drugs for the treatment of neuropathic pain in a patient with lacunar infarcts in the medulla oblongata. The treatment of CPSP is a difficult task due to the insufficiently unexplored mechanisms of development, the most effective approaches are those aimed at reducing the increased excitability of neurons.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.
acute ischemic stroke; central post-stroke pain; lacunar infarcts; medulla oblongata; Migraine; adult; article; blood pressure measurement; brain circulus arteriosus; burn; burning sensation; case report; central pain syndrome; cholecystitis; chronic viral hepatitis; clinical article; computer assisted tomography; coronavirus disease 2019; diplopia; dizziness; electrocardiogram; fatigue; female; gliosis; hormonal contraception; hormone substitution; hospital admission; human; intensive care unit; jaw movement; lacunar infarction; lung auscultation; magnetic resonance angiography; maintenance therapy; middle aged; migraine/dt [Drug Therapy]; migraine/pc [Prevention]; migraine without aura/dt [Drug Therapy]; minimally conscious state; motoneuron; muscle strength; nasolabial fold; nausea; neurologist; neuropathic pain; paresthesia; parietal lobe; physical examination; posterior cerebral artery; primary headache; recommended drug dose; renal angiomyolipoma; secondary headache; smoking cessation; thrombocytopenia; tobacco dependence; tongue disease; vomiting; walking difficulty; amitriptyline/dt [Drug Therapy]; carbamazepine/dt [Drug Therapy]; dydrogesterone plus estradiol/dt [Drug Therapy]; indometacin/dt [Drug Therapy]; pregabalin/dt [Drug Therapy]
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Database:
EMBASE
Language:
English
Journal:
Biomedicine (India)
Year:
2023
Document Type:
Article
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