OVERVIEW
Overview of Migraine
Migraine with basilar artery refers to a brainstem neurologic dysfunction that precedes the onset of a migraine attack, and is classified as a migraine with aura, often accompanied by visual disturbances and changes in consciousness. The third edition of the International Classification of Headache was renamed Brainstem Migraine with Aura.
Whether medical insurance
Yes, it is
Department
Neurology
Synonyms
Brainstem migraine with aura; Basilar artery migraine; Basilar migraine; Basilar migraine
Clinical Symptoms
Periodic episodes of throbbing headache preceded by aura symptoms such as diplopia, vertigo, tinnitus, and dysarthria.
Hazards
Severe symptoms may include transient loss of consciousness and syncope, increasing the risk of accidents.
Examination
Physical examination, funduscopic examination, EEG, CT, MRI, TCD, etc.
Diagnosis
Diagnosis is made on the basis of medical history, episodic headache, aura symptoms such as diplopia, vertigo, tinnitus, dysarthria, etc., combined with EEG, CT, MRI and other examinations.
Treatment principle
Symptomatic treatment and preventive treatment. Analgesic treatment is the mainstay during the seizure period, and preventive treatment is the mainstay during the intermittent period.
Curability
Active treatment can relieve symptoms.
Dietary recommendations
Moderate diet, low-fat diet, avoid pickled and smoked foods, avoid smoking and alcohol.
Etiology
Epidemiology
Most common in children and young women.
Etiology
May be related to heredity, diet, endocrine factors and so on. It is generally believed that the neurological abnormalities occur due to ischemia of the brainstem, cerebellum, and occipital lobe caused by vasospasm of the basilar artery and its branches due to invasion of the basilar artery.
Symptoms and Diagnosis
Typical symptoms
Before the onset of migraine, aura symptoms such as transient bilateral visual disturbances (flashes of light, dark spots, blurred bilateral vision or total blindness, etc.), diplopia, dizziness, tinnitus, dysarthria, perioral or lingual numbness, numbness of limbs, ataxia, etc., and consciousness disorders such as transient disorientation and loss of autonomous activities, fainting, or psychosis, etc., can occur in the peak period. The aura period lasts several minutes or tens of minutes after the emergence of severe headache, headache is mainly located in the occipital region, bilateral throbbing headache, radiating to the back of the neck, often accompanied by nausea, vomiting, etc., which can last for several hours or days. Most headache attacks are frequent and may occur several times a week with varying regularity of intervals. A few patients have transient limited or generalized seizures.
Diagnostic basis
1. Episodic throbbing headache is preceded by aura symptoms such as transient bilateral visual disturbances (flashes of light, dark spots, bilateral blurred vision or total blindness, etc.), diplopia, vertigo, tinnitus, dysarthria, perioral or lingual numbness, numbness of limbs, ataxia, and so on.
2. Electroencephalogram (EEG): slow waves in the occipital region can be seen during the seizure period, which may be paroxysmal or last for several days or weeks to return to normal. There is no abnormality in the intermittent period.
3. Auxiliary examination may include cranial CT, MRI and other imaging examinations to exclude organic lesions.
Treatment
Treatment policy
Avoid triggering factors, focus on analgesic treatment during the attack period, and focus on preventive treatment during the intermittent period.
Drug treatment
1. Seizure treatment
(1) For migraine with infrequent and less intense attacks, non-steroidal anti-inflammatory and analgesic drugs, such as acetylsalicylic acid, can be given during the attack. Antiepileptic drugs such as sodium valproate can also be tried.
(2) infrequent attacks but very strong migraine, can be given to Tretinoin, Tretinoin treatment recurrence can be used again or change other agents or dosage, the patient is not effective for a Tretinoin may be effective for another, headache lasts for a long time the patient can use caffeine ergotamine.
(3) For severe vomiting, dopamine peripheral receptor antagonists may be added, as well as sedatives.
2. Treatment during remission
For those who have more than 2 episodes per month, drugs such as phenothiazine and propranolol can be used for treatment.
Prognosis
Basilar artery type migraine has no tendency to deteriorate and has a good prognosis. A small number of patients may evolve into common type migraine, which occasionally leads to thrombosis of basilar artery or posterior cerebral artery after repeated attacks.
Nursing care
Daily care
Keep the indoor air fresh, open the windows regularly for ventilation.
Rest and ActivityLife is regular, reasonable rest, ensure sleep time and sleep quality; avoid excessive physical and mental fatigue, moderate physical exercise.
Set up safety handrails in corridors, toilets and bathrooms, and use protective devices when necessary to ensure the safety of the surrounding environment, and keep the ground dry, level and free of obstacles.
Adhere to the medication prescribed by the doctor, do not increase, decrease or stop the medication on your own.
Diet
Moderate diet, low-fat diet, avoid pickled and smoked food, avoid smoking, avoid alcohol.