title: Reversible cerebral vasoconstriction syndrome presenting as subarachnoid hemorrhage, reversible posterior leukoencephalopathy, and cerebral infarction.
abstract: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute severe headache with or without additional neurological symptoms and reversible cerebral vasoconstriction. Unruptured aneurysm has been reported in some cases with RCVS. We report a severe case of a 53-year-old woman with RCVS having an unruptured cerebral aneurysm and presenting as cortical subarachnoid hemorrhage, reversible posterior leukoencephalopathy syndrome, and cerebral infarction. She was successfully treated with corticosteroids and a calcium channel blocker and the aneurysm was clipped. Her various complications are due to the responsible vasoconstriction that started distally and progressed towards proximal arteries. This case demonstrates the spectrum of presentations of RCVS, a clinically complicated condition.
authors.affiliation: Department of Neurology, Juntendo University Shizuoka Hospital, Japan. k-noda@juntendo.ac.jp
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Noda
authors.forename: Jiro
authors.initials: J
authors.lastname: Fukae
authors.forename: Kenji
authors.initials: K
authors.lastname: Fujishima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okuma
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000792:Angiography; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D014661:Vasoconstriction
chemical_list: D000305:Adrenal Cortex Hormones; D002121:Calcium Channel Blockers