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


CONCLUSIONS
It is important for physicians who care for patients with aneurysmal SAH to recognize RCVS, as the treatments for these two conditions are different.
Nickele
Christopher
C
Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Muro
Kenji
K
Getch
Christopher C
CC
Walker
Matthew T
MT
Bernstein
Richard A
RA
D017542:Aneurysm, Ruptured / Q000175:diagnosis*; D002941:Circle of Willis; D003251:Constriction, Pathologic / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D013577:Syndrome; D020301:Vasospasm, Intracranial / Q000175:diagnosis*