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Erschienen in: Neurocritical Care 1/2007

01.08.2007 | Original Paper

Severe reversible cerebral vasoconstriction syndrome mimicking aneurysmal rupture and vasospasm

verfasst von: Christopher Nickele, Kenji Muro, Christopher C. Getch, Matthew T. Walker, Richard A. Bernstein

Erschienen in: Neurocritical Care | Ausgabe 1/2007

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Abstract

Introduction

Presenting symptoms of aneurysmal subarachnoid hemorrhage (SAH) and reversible cerebral vasoconstriction syndrome (RCVS) may overlap. Patients with RCVS often harbor unruptured aneurysms.

Summary of Case

We report a case of RCVS in a patient with an unruptured intracranial aneurysm. The development of diffuse vasoconstriction after aneursym clipping in the absence of any subarachnoid blood was initially confusing, until subtle vasoconstriction before clipping was seen retrospectively.

Results

We obtained perfusion and diffusion MRI studies on this patient, which shed light on the pathophysiology of RCVS.

Conclusion

It is important for physicians who care for patients with aneurysmal SAH to recognize RCVS, as the treatments for these two conditions are different.
Literatur
1.
Zurück zum Zitat Singhal AB, Bernstein RA. Postpartum angiopathy and other cerebral vasoconstriction syndromes. Neurocrit Care 2005;3(1):91–7.PubMedCrossRef Singhal AB, Bernstein RA. Postpartum angiopathy and other cerebral vasoconstriction syndromes. Neurocrit Care 2005;3(1):91–7.PubMedCrossRef
2.
Zurück zum Zitat Bernstein RA. Reversible cerebral vasoconstriction syndromes. Curr Treat Options Cardiovasc Med 2006;8:229–34.PubMedCrossRef Bernstein RA. Reversible cerebral vasoconstriction syndromes. Curr Treat Options Cardiovasc Med 2006;8:229–34.PubMedCrossRef
3.
Zurück zum Zitat Call GK, Fleming MC, Sealfon S, Levine H, Kistler JP, Fisher CM. Reversible cerebral segmental vasoconstriction. Stroke 1988;19(9):1159–70.PubMed Call GK, Fleming MC, Sealfon S, Levine H, Kistler JP, Fisher CM. Reversible cerebral segmental vasoconstriction. Stroke 1988;19(9):1159–70.PubMed
4.
Zurück zum Zitat Ringer AJ, Qureshi AI, Kim SH, Fessler RD, Guterman LR, Hopkins LN. Angioplasty for cerebral vasospasm from eclampsia. Surg Neurol 2001;56(6):373–8, (discussion 378–9).PubMedCrossRef Ringer AJ, Qureshi AI, Kim SH, Fessler RD, Guterman LR, Hopkins LN. Angioplasty for cerebral vasospasm from eclampsia. Surg Neurol 2001;56(6):373–8, (discussion 378–9).PubMedCrossRef
5.
Zurück zum Zitat Singhal AB, Caviness VS, Begleiter AF, Mark EJ, Rordorf G, Koroshetz WJ. Cerebral vasoconstriction and stroke after use of serotonergic drugs.[see comment]. Neurology 2002;58(1):130–3.PubMed Singhal AB, Caviness VS, Begleiter AF, Mark EJ, Rordorf G, Koroshetz WJ. Cerebral vasoconstriction and stroke after use of serotonergic drugs.[see comment]. Neurology 2002;58(1):130–3.PubMed
6.
Zurück zum Zitat Singhal AB. Postpartum angiopathy with reversible posterior leukoencephalopathy. Arch Neurol 2004;61(3):411–6.PubMedCrossRef Singhal AB. Postpartum angiopathy with reversible posterior leukoencephalopathy. Arch Neurol 2004;61(3):411–6.PubMedCrossRef
7.
Zurück zum Zitat Day JW, Raskin NH. Thunderclap headache: symptom of unruptured cerebral aneurysm. Lancet 1986;2(8518):1247–8.PubMed Day JW, Raskin NH. Thunderclap headache: symptom of unruptured cerebral aneurysm. Lancet 1986;2(8518):1247–8.PubMed
8.
Zurück zum Zitat Singhal AB. Thunderclap headache, reversible cerebral arterial vasoconstriction, and unruptured aneurysms.[comment]. J Neurol Neurosurg Psychiatry 2002;73(1):96, (author reply 96–7).PubMedCrossRef Singhal AB. Thunderclap headache, reversible cerebral arterial vasoconstriction, and unruptured aneurysms.[comment]. J Neurol Neurosurg Psychiatry 2002;73(1):96, (author reply 96–7).PubMedCrossRef
9.
Zurück zum Zitat Calabrese LH. Vasculitis of the central nervous system. Rheum Dis Clin North Am 1995;21(4):1059–76.PubMed Calabrese LH. Vasculitis of the central nervous system. Rheum Dis Clin North Am 1995;21(4):1059–76.PubMed
10.
Zurück zum Zitat Caplan LR, Hennerici M. Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Arch Neurol 1998;55(11):1475–82.PubMedCrossRef Caplan LR, Hennerici M. Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke. Arch Neurol 1998;55(11):1475–82.PubMedCrossRef
Metadaten
Titel
Severe reversible cerebral vasoconstriction syndrome mimicking aneurysmal rupture and vasospasm
verfasst von
Christopher Nickele
Kenji Muro
Christopher C. Getch
Matthew T. Walker
Richard A. Bernstein
Publikationsdatum
01.08.2007
Verlag
Humana Press Inc
Erschienen in
Neurocritical Care / Ausgabe 1/2007
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-007-0001-4

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