Reversible Cerebral Vasoconstriction Syndrome: A Commonly Missed Diagnosis in Acute Severe Headaches

Siriporn Hirunpat; Nuttha Sanghan; Adchara Wan-ai; Natee Ina; Pornrujee Hirunpat

doi:10.46475/aseanjr.v19i2.34

Authors

Siriporn Hirunpat Department of Radiology, Faculty of Medicine, Prince of Songkla University
Nuttha Sanghan Department of Radiology, Faculty of Medicine, Prince of Songkla University
Adchara Wan-ai Department of Radiology, Faculty of Medicine, Prince of Songkla University
Natee Ina Department of Radiology, Faculty of Medicine, Prince of Songkla University
Pornrujee Hirunpat Department of Radiology, Faculty of Medicine, Prince of Songkla University

DOI:

https://doi.org/10.46475/aseanjr.v19i2.34

Abstract

Summary: In spite of the recent acceptance to be a common cause of acute severe headaches, reversible cerebral vasoconstriction syndrome (RCVS) is still commonly missed. The syndrome is characterized by acute severe headaches due to the vasoconstriction of the cerebral arteries, which eventually resolve spontaneously. We present a reported case of RCVS with a typical magnetic resonance angiography (MRA) appearance and a review of the literature.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Call GK, Fleming MC, Sealfon S, Levine H, Kistler JP, Fisher CM. Reversible cerebral segmental vasoconstriction. Stroke 1988;19:1159-70.

Calabrese LH, Gragg LA, Furlan AJ. Benign angiopathy: a distinct subset of angiographically defined primary angiitis of the central nervous system. J Rheumatol 1993;20: 2046-50.

Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol 2012;11:906-917.

Velez A, McKinney J. Reversible Cerebral Vasoconstriction Syndrome: A Review of Recent Research. Current Neurology and Neuroscience Reports 2012;13:1-5.

Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser M. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome: a prospective series of 67 patients. Brain 2007;130:3091-101.

Singhal A, Hajj-Ali R, Topcuoglu M, Fok J, Bena J, Yang D, et al. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol 2011;68:1005-12.

Ducros A, Bousser MG. Reversible cerebral vasoconstriction syndrome. Pract Neurol 2009;9:256-67.

Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Narrative Review: Reversible Cerebral Vasoconstriction Syndromes. Annals of Internal Medicine 2007;146:34-44.

Chen SP, Fuh JL, Lirng JF, Chang FC, Wang SJ. Recurrent primary thunderclap headache and benign CNS angiopathy: spectra of the same disorder? Neurology 2006;67:2164-9.

Chen SP, Fuh JL, Wang SJ. Reversible cerebral vasoconstriction syndrome: current and future perspectives. Expert Rev Neurother 2011;11:1265-76.

Chen S, Fuh J, Wang S. Reversible cerebral vasoconstriction syndrome: an under-recognized clinical emergency. Ther Adv Neurol Disord 2010;3:161-71.

Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013;33:629-808.

Cheng Y-C, Kuo K-H, Lai T-H. A common cause of sudden and thunderclap headaches: reversible cerebral vasoconstriction syndrome. J Headache Pain 2014;15:13.

Tan LH, Flower O. Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Acute Severe Headache. Emergency Medicine International 2012;2012:8.

Koopman K, Teune LK, ter Laan M, Uyttenboogaart M, Vroomen PC, De Keyser J, et al. An often unrecognized cause of thunderclap headache: reversible cerebral vasoconstriction syndrome. J Headache Pain 2008;9:389-91.

Hijikata Y, Watanabe H, Ito M, Yoneyama N, Atsuta N, Sobue G. Reversible cerebral vasoconstriction syndrome (RCVS) triggered by nicotine patches. Rinsho Shinkeigaku 2013;53:721-3.

Marder CP, Donohue MM, Weinstein JR, Fink KR. Multimodal Imaging of Reversible Cerebral Vasoconstriction Syndrome: A Series of 6 Cases. American Journal of Neuroradiology 2012;33:1403-11.

Hajj-Ali RA, Furlan A, Abou-Chebel A, Calabrese LH. Benign angiopathy of the central nervous system: Cohort of 16 patients with clinical course and long-term followup. Arthritis Care & Research 2002;47:662-9.

Mandell DM, Matouk CC, Farb RI, Krings T, Agid R, terBrugge K, et al. Vessel Wall MRI to Differentiate Between Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis: Preliminary Results. Stroke 2012;43:860-2.

Elstner M, Linn J, Muller-Schunk S, Straube A. Reversible cerebral vasoconstriction syndrome: a complicated clinical course treated with intra-arterial application of nimodipine. Cephalalgia 2009;29:677-82.

Linn J, Fesl G, Ottomeyer C, Straube A, Dichgans M, Bruckmann H, et al. Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a diagnostic tool in select cases? Cephalalgia 2011;31: 1074-81.

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: 648-56.

Marder CP, Donohue MM, Weinstein JR, Fink KR. Multimodal imaging of reversible cerebral vasoconstriction syndrome: a series of 6 cases. AJNR Am J Neuroradiol 2012;33:1403-10.

Sattar A, Manousakis G, Jensen MB. Systematic review of reversible cerebral vasoconstriction syndrome. Expert Rev Cardiovasc Ther 2010;8:1417-21.

Saini M, Jeerakathil T, Butcher K. Reversible cerebral vasoconstriction syndrome. Neurol India 2009;57:63-5.

Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain 2007;130:3091-101.

Lu SR, Liao YC, Fuh JL, Lirng JF, Wang SJ. Nimodipine for treatment of primary thunderclap 28. 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;41:2505-11.

Bartynski WS, Boardman JF. Catheter angiography, MR angiography, and MR perfusion in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol 2008;29:447-55.

Edlow B, Kasner S, Hurst R, Weigele J, Levine J. Reversible Cerebral Vasoconstriction Syndrome Associated with Subarachnoid Hemorrhage. Neurocritical Care 2007;7: 203-10.

Muehlschlegel S, Kursun O, Topcuoglu MA, Fok J, Singhal AB. DIfferentiating reversible cerebral vasoconstriction syndrome with subarachnoid hemorrhage from other causes of subarachnoid hemorrhage. JAMA Neurology 2013;70:1254-60.

Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser M-G. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain 2007;130:3091-101.

Kumar S, Goddeau RP, Selim MH, Thomas A, Schlaug G, Alhazzani A, et al. Atraumatic convexal subarachnoid hemorrhage: Clinical presentation, imaging patterns, and etiologies. Neurology 2010;74:893-9.

Singhal A, Bernstein R. Postpartum angiopathy and other cerebral vasoconstriction syndromes. Neurocritical Care 2005;3:91-7.

Dodick D. Reversible Segmental Cerebral Vasoconstriction (Call-Fleming Syndrome): the Role of Calcium Antagonists. Cephalalgia 2003;23:163-5.

Lu S-R, Liao Y-C, Fuh J-L, Lirng J-F, Wang S-J. Nimodipine for treatment of primary thunderclap headache. Neurology 2004;62:1414-6.

Werring DJ. Reversible Cerebral Vasoconstriction Syndrome and Intracranial Hemorrhage: Some Answers, Many Questions. Stroke 2010;41:2455-6.