Hernández VLA, de Lera AM

Language: Spanish
References: 12
Page: 535-541
PDF size: 273.95 Kb.

ABSTRACT

Background: Reversible cerebral vasoconstriction syndrome is a disease whose incidence is unknown, in which segmental and reversible vasoconstriction of the cerebral arteries occurs, and is characterized by severe thunderclap headache, which may or may not be accompanied by neurological deficit.
Clinical cases: A 52-year-old female patient, with a history of 2 pregnancies and 2 deliveries and recent onset of climacteric, with dysregulation of the menstrual cycle and obesity. She presented a headache of 4 days of evolution, of severe intensity, palpitations, photophobia, sweating, nausea and vomiting. The neurological examination did not reveal any neurological deficit. Brain CT showed right fronto-parietal subarachnoid hemorrhage. The arteriography revealed multiple segmental stenosis in all vascular territories. During her admission, nimodipine was administered, and controls were performed with transcranial echo-Doppler, showing favorable clinical evolution.
Conclusions: Reversible cerebral vasoconstriction syndrome constitutes a diagnostic challenge, given the different forms of presentation and the different causes and factors that can trigger it. The mechanisms involved in its production are partly unknown; however, within the reported associations it has been suggested that sex hormones play an important role in its pathogenesis, but more scientific evidence is needed to clarify this association.

REFERENCES

1. Sorensen DM. Reversible cerebral vasoconstriction syndromeor posterior reversible encephalopathy syndromereply.JAMA Neurol 2016; 73 (5) :606-7. https://doi.org/10.1001/jamaneurol.2015.5110

2. Calic Z, Cappelen-Smith C, Zagami AS. Reversible cerebralvasoconstriction syndrome. Intern Med J 2015; 45 (6):599-608. https://doi.org/10.1111/imj.12669

3. Néel A, Guillon B, Auffray-Calvier E, Hello M, HamidouM. Le syndrome de vasoconstriction cérébrale réversible.Rev Med Interne 2012; 33 (10): 586-92. https://doi.org/10.1016/j.revmed.2012.05.004

4. Arrigan MT, Heran MKS, Shewchuk JR. Reversible cerebral vasoconstrictionsyndrome: an important and common causeof thunderclap and recurrent headaches. Clin Radiol 2018;73 (5): 417-27. https://doi.org/10.1016/j.crad.2017.11.017

5. Chen SP, Wang SJ. Pathophysiology of reversible cerebralvasoconstriction syndrome. J Biomed Sci 2022; 29 (1): 72.https://doi.org/10.1186/s12929-022-00857-4

6. Chen SP, Yang AC, Fuh JL, Wang SJ. Autonomic dysfunctionin reversible cerebral vasoconstriction syndromes. J HeadachePain 2013; 14 (1): 94. https://doi.org/10.1186/1129-2377-14-94

7. Yancy H, Lee-Iannotti JK, Schwedt TJ, Dodick DW. Reversiblecerebral vasoconstriction syndrome. Headache 2013; 53(3): 570-6. https://doi.org/10.1111/head.12040

8. Sadeghizadeh A, Pourmoghaddas Z, Zandifar A, Tara SZ,et al. Reversible cerebral vasoconstriction syndrome andmultisystem inflammatory syndrome in children withCOVID-19. Pediatr Neurol 2022; 129: 1-6. https://doi.org/10.1016/j.pediatrneurol.2021.12.013

9. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversiblecerebral vasoconstriction syndrome, part 1: Epidemiology,pathogenesis, and clinical course. AJNR Am J Neuroradiol2015; 36 (8): 1392-9. https://doi.org/10.3174/ajnr.A4214

10. Ducros A. Reversible cerebral vasoconstriction syndrome.Lancet Neurol 2012; 11 (10): 906-17. https://doi.org/10.1016/S1474-4422(12)70135-7

11. Burton TM, Bushnell CD. Reversible cerebral vasoconstrictionsyndrome. Stroke 2019; 50 (8): 2253-8. https://doi.org/10.1161/STROKEAHA.119.024416

12. Song TJ, Lee KH, Li H, Kim JY, et al. Reversible cerebralvasoconstriction syndrome: a comprehensive systematicreview. Eur Rev Med Pharmacol Sci 2021; 25 (9): 3519-29.https://doi.org/10.26355/eurrev_202105_25834