Reversible cerebral vasoconstriction syndrome: case report.
A 28-year-old woman had thunderclap headache (TCH), after 7 days she had left hemiparesis. She had a history of oral contraceptive and citalopram medications. Brain magnetic resonance (MR) angiography demonstrated multiple stenotic segments. Digital subtraction angiography (DSA) showed multiple segments of narrowing in vessel calibre. Two probable diagnoses performed; primary angiitis of the central nervous system and reversible cerebral vasoconstriction syndrome (RCVS). Because of clinical characteristics and normal cerebrospinal fluid findings she was set on medication for probable RCVS. Follow-up MR angiography after 4 weeks and DSA after 7 weeks demonstrated improvement in vessel calibre. Thus, diagnosis RCVS was established. Diagnosis and management of TCH contain many potential difficulties. Clinicians should consider the imaging of cerebral arteries, even if computed tomography scan and lumbar puncture are normal in TCH. Potential precipitating factors and triggers should also be known and avoided.
Neurology Department, Gülhane Military Medical Academy, Etlik, Ankara, Turkey. oz_oguzhan@yahoo.com
Oğuzhan
O
Oz
Seref
S
Demirkaya
Semai
S
Bek
Erdal
E
Eroğlu
Umit Hidir
UH
Ulaş
Zeki
Z
Odabaşi
D000328:Adult; D015901:Angiography, Digital Subtraction; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015283:Citalopram / Q000009:adverse effects; D003276:Contraceptives, Oral / Q000627:therapeutic use; D017308:Etodolac / Q000627:therapeutic use; D005260:Female; D051270:Headache Disorders, Primary / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D010291:Paresis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology*; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002121:Calcium Channel Blockers; D015283:Citalopram; D003276:Contraceptives, Oral; D017308:Etodolac; D010975:Platelet Aggregation Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors