Reversible cerebral vasoconstriction syndrome and bilateral vertebral artery dissection presenting in a patient after cesarean section.
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset thunderclap headache and focal neurologic deficits. Once thought to be a rare syndrome, more advanced non-invasive imaging has led to an increase in RCVS diagnosis. Unilateral vertebral artery dissection has been described in fewer than 40% of cases of RCVS. Bilateral vertebral artery dissection has rarely been reported. We describe the case of a patient with RCVS and bilateral vertebral artery dissection presenting with an intramedullary infarct treated successfully with medical management and careful close follow-up. This rare coexistence should be recognized as the treatment differs.
Department of Radiology, Stanford University Medical Center, Stanford, CA, USA.
Lex A
LA
Mitchell
Justin G
JG
Santarelli
Inder Paul
IP
Singh
Huy M
HM
Do
D001241:Aspirin; D002533:Cerebral Angiography; D002585:Cesarean Section; D000077144:Clopidogrel; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000175:diagnosis*; D013577:Syndrome; D013988:Ticlopidine / Q000031:analogs & derivatives; D014057:Tomography, X-Ray Computed; D014661:Vasoconstriction; D020301:Vasospasm, Intracranial / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis*; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000175:diagnosis*
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin