DOI: 10.12890/2020_001839
Reversible Cerebral Vasoconstriction Syndrome Associated with Infundibular Dilation
Authors
dr.montenegrorx@gmail.com
Keywords
Reversible cerebral vasoconstriction syndrome, sudden-onset severe headacheAbstract
Background: Reversible cerebral vasoconstriction syndrome (RCVS) is defined as a clinical and radiological syndrome that comprises a group of disorders characterized by sudden-onset severe headache and segmental vasoconstriction of the cerebral arteries with resolution within 3 months.
Case presentation: A 51-year-old female patient with a 2-week history of sudden-onset severe headache, visual disturbances and cerebellum; no relevant imaging findings, except for an infundibular dilation at the origin of the posterior communicating artery, and so, angiography was performed. When symptoms persisted, a new imaging study was carried out with findings of RCVS as the cause of the symptoms from the beginning.
Conclusions: Findings of RCVS can be obtained in various vasculopathies of the nervous system and vasculitis, being misdiagnosed, and so, clinical suspicion is essential; if vasoconstriction is not demonstrated on the initial image and other diagnoses have been excluded, the patient should be managed as having possible or probable RCVS.
References
- Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vasoconstriction syndrome, part 1: epidemiology, pathogenesis, and clinical course. Am J Neuroradiol 2015;36(8):1392–1399.
- Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. Am J Neuroradiol 2008;29(6):1043–1049.
- Ansari SA, Rath TJ, Gandhi D. Reversible cerebral vasoconstriction syndromes presenting with subarachnoid hemorrhage: a case series. J Neurointerv Surg 2011;3(3):272–278.
- Chen SP, Fuh JL, Wang SJ, Chang FC, Lirng JF, Fang YC, et al. Magnetic resonance angiography in reversible cerebral vasoconstriction syndromes. Ann Neurol 2010;67(5):648–656.
- Marder CP, Donohue MM, Weinstein JR, Fink KR. Multimodal imaging of reversible cerebral vasoconstriction syndrome: a series of 6 cases. Am J Neuroradiol 2012;33(7):1403–1410.
- Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med 2007;146(1):34–44.
- Burton TM, Bushnell CD. Reversible cerebral vasoconstriction syndrome: a diagnostic imaging review. Stroke 2019;50(8):2253–2258.
- Ducros A, Fiedler U, Porcher R, Boukobza M, Stapf C, Bousser MG. Hemorrhagic manifestations of reversible cerebral vasoconstriction syndrome: frequency, features, and risk factors. Stroke 2010;41(11):2505–2511.
- Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. Am J Neuroradiol 2008;29(6):1036–1042.
- Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol 2012;11(10):906–917.