자발중대뇌동맥박리의 유일한 증상으로 발현한 체위두통

초록

Spontaneous intracranial artery dissection is uncommon. Although dissection of the extracranial cervical arteries and vertebral arteries has been extensively studied and described, less information is available about pure intracranial artery dissection. It is difficult to diagnose and perform intracranial arterial dissection in patients who present with only symptoms of headache without any neurologic deficits or previous trauma history. We describe a case of positional headache cause by isolated middle cerebral artery dissection, confirmed by high-resolution magnetic resonance imaging (HR-MRI). The patient experienced sudden onset of headache while lying down in the decubitus position in the same direction as the middle cerebral artery dissection site. In conclusion, we suggest that the possibility of intracranial artery dissection should be considered in patients with a headache that changes with position and it is important to consider additional examinations such as high-resolution magnetic resonance imaging.

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