片頭痛性脳梗塞による一致性同名半盲の1例

Congruous homonymous hemianopia in a case of migrainous cerebral infarction

　31歳，妊娠23週の妊婦で臨床経過および画像所見から，migrainous infarctionによると思われる一致性同名半盲の症例を報告した。頭部MRI検査において，右視放線から一次視覚領前部にかけて亜急性出血性脳梗塞を示す所見があり，片頭痛発作後に生じた一致性同名半盲の責任病巣と考えられた。片頭痛患者の眼症状は，閃輝性暗点に代表される一過性の視野異常が大部分であるが，片頭痛患者のなかには本症のように長期にわたる視野障害を弓き起こすことがあることを十分念頭におくべきと考えられた。

A 31-year-old female at 23 weeks' pregnancy presented with left homonymous hemianopia since one week before. She had repeated attacks of migraine for over 10 years. The hemianopia was preceded by an attack of of right hemicrania with scintillating scotoma. Magnetic resonance imaging showed features consistent with subacute hemorrhagic infarction in the right optic radiation and anterior visual cortex. Clinical findings were also consistent with the diagnosis of migrainous infarction. This case illustrates that occipital hemianopia may be induced by migrainous attack followed by cerebral infarction.