Reversible Cerebral Vasoconstriction Syndrome: A Common Occurrence but Rare Diagnosis

Curēus
Brian GrundtMark L Ritch

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is an under-diagnosed condition that results from reversible segmental and multifocal vasoconstriction of cerebral arteries. It can present with a variety of symptoms including sudden "thunder clap" headaches, neurologic deficits, photophobia, phonophobia, nausea, vomiting, and can mimic life-threatening conditions such as a ruptured intracranial aneurysm, primary angiitis of the central nervous system, and cervical artery dissection. The pathology of this condition is still not fully understood and the etiologies vary, making treatment difficult. Our objective is to draw attention to an under-diagnosed condition with common presenting symptoms. We present a 60-year-old male with sudden onset of severe headache, left-sided numbness and weakness, blurred vision, ataxia, nausea, and dyspnea. CT and MRI brain showed no evidence of infarct or hemorrhage. CT angiography (CTA) of the head and neck showed a narrow caliber basilar artery. With the patient's clinical presentation and imaging findings, RCVS was suspected and the patient was started on a calcium channel blocker and glucocorticoids. A repeat CTA of the head and neck was performed after initiation of therapy and showed di...Continue Reading

References

Jan 4, 2007·Annals of Internal Medicine·Leonard H CalabreseAneesh B Singhal
Dec 24, 2010·Therapeutic Advances in Neurological Disorders·Shih-Pin ChenShuu-Jiun Wang
Nov 15, 2013·Therapeutic Advances in Neurological Disorders·Dagny Holle, Mark Obermann
May 1, 2017·Current Treatment Options in Neurology·Cecilia Cappelen-SmithDennis Cordato
Sep 25, 2017·The American Journal of Medicine·Paul Rizzoli, William J Mullally

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