title: Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a diagnostic tool in select cases?
abstract: BACKGROUND
  Differential diagnoses of the reversible cerebral vasoconstriction syndrome (RCVS) include all forms of intracranial stenotic disease, such as primary or secondary vasculitis of the central nervous system. Here, we tested the hypothesis that angiographic response to intra-arterial nimodipine application may be helpful in differentiating between RCVS and other entities.
  
  
  METHODS
  A digital subtraction angiographic (DSA) series of nine consecutive patients with suspected RCVS that were treated by intra-arterial nimodipine due to clinical worsening were retrospectively analyzed. Pre- and post-therapeutic DSA findings of patients with later-confirmed RCVS were compared to those in which another diagnosis was finally made.
  
  
  RESULTS
  Intra-arterial nimodipine resulted in a normalization of both the diameter of the main trunks of the cerebral vessels and the caliber of the peripheral vessels in all RCVS patients. This was not the case in the non-RCVS patients, in whom only a slight general vasodilatation was observed.
  
  
  CONCLUSIONS
  Our preliminary results indicate that angiographic response to intra-arterial application might be a helpful differential diagnostic tool in select patients with suspected RCVS.
authors.affiliation: University Hospital Munich, Germany. linn@nrad.de
authors.forename: J
authors.initials: J
authors.lastname: Linn
authors.forename: G
authors.initials: G
authors.lastname: Fesl
authors.forename: C
authors.initials: C
authors.lastname: Ottomeyer
authors.forename: A
authors.initials: A
authors.lastname: Straube
authors.forename: M
authors.initials: M
authors.lastname: Dichgans
authors.forename: H
authors.initials: H
authors.lastname: Bruckmann
authors.forename: T
authors.initials: T
authors.lastname: Pfefferkorn
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007261:Infusions, Intra-Arterial; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000008:administration & dosage; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D014665:Vasodilator Agents; D009553:Nimodipine