title: Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients.
abstract: OBJECTIVE
  To describe clinical-radiologic characteristics in a prospective series of patients having both confirmed reversible cerebral vasoconstriction syndrome (RCVS) and cervical artery dissection (CeAD).
  
  
  METHODS
  From January 2004 to December 2011, from our prospective cohorts of RCVS and CeAD, we studied patients with both conditions.
  
  
  RESULTS
  Of 173 RCVS cases and 285 CeAD cases, 20 patients (18 women, 2 men; mean age 41 years) had both RCVS and CeAD. Main associated conditions were migraine (12/20) and postpartum (5/18). Clinical features included severe headache in all patients, neck pain in 15, focal neurologic deficit in 9, and seizures in 4. Pain was the only symptom in 10 patients. All patients had multifocal cerebral vasoconstriction. There were brain lesions in 12 patients, cortical subarachnoid hemorrhage in 11, posterior reversible encephalopathy syndrome in 4, intracerebral hemorrhage in 3, and infarcts in 4. CeAD involved one artery in 13 patients and multiple arteries in 7. CeAD mostly affected vertebral arteries (25 of 30 CeAD). Only one vertebral CeAD was associated with a related symptomatic infarct. At 3 months, 18 patients had fully recovered, all patients showed reversal of cerebral vasoconstriction, and 21 dissected arteries had normalized, whereas 9 arteries showed residual stenosis (7) and/or aneurysm (3).
  
  
  CONCLUSIONS
  The association of RCVS and CeAD was found in 12% of our patients with RCVS and 7% of our patients with CeAD. Underlying mechanisms are unknown. In practice, our results point to the need for a systematic study of both cervical and intracranial arteries in the 2 conditions.
authors.affiliation: Neurology Department , Head and Neck Clinic, Lariboisière Hospital, Assistance Publique des Hôpitaux de Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Mawet
authors.forename: Monique
authors.initials: M
authors.lastname: Boukobza
authors.forename: Julie
authors.initials: J
authors.lastname: Franc
authors.forename: Mariana
authors.initials: M
authors.lastname: Sarov
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
authors.forename: Marie-Germaine
authors.initials: MG
authors.lastname: Bousser
authors.forename: Anne
authors.initials: A
authors.lastname: Ducros
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000601:surgery; D002539:Cerebral Arterial Diseases / Q000150:complications* / Q000601:surgery; D005260:Female; D051270:Headache Disorders, Primary / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000601:surgery; D014661:Vasoconstriction; D020301:Vasospasm, Intracranial / Q000150:complications* / Q000601:surgery