title: Initial vasodilatation in a child with reversible cerebral vasoconstriction syndrome.
abstract: We describe the case of a 10-year-old boy who developed reversible cerebral vasoconstriction syndrome (RCVS) after cerebellitis. He received intravenous immunoglobulin and methylprednisolone to treat the cerebellitis. However, he then presented with a sudden severe headache, vomiting, and generalized tonic-clonic seizure. Brain magnetic resonance angiography (MRA) initially revealed diffuse cerebral vasodilatations, and diffuse multifocal segmental vasoconstrictions developed several days later. His clinical symptoms gradually resolved after several days, in the absence of any specific therapy. MRA performed 46days after symptom onset showed that the multifocal segmental vasoconstrictions had resolved, suggesting a diagnosis of RCVS. The imaging features of RCVS include multifocal segmental vasoconstriction. However, our case suggests that diffuse cerebral vasodilatation may in fact be evident during the early stage of disease.
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Yukimune
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Yurika
authors.initials: Y
authors.lastname: Numata-Uematsu
authors.affiliation: Division of Pediatrics, Sendai City Hospital, Sendai, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Aihara
authors.affiliation: Division of Pediatrics, Sendai City Hospital, Sendai, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Division of Pediatrics, Sendai City Hospital, Sendai, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Takayanagi
authors.affiliation: National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, NHO, Shizuoka, Japan.
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kure
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan. Electronic address: uematsu@bk9.so-net.ne.jp.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002648:Child; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D013577:Syndrome; D014661:Vasoconstriction; D014664:Vasodilation
keywords: Diffuse cerebral vasodilatations; Magnetic resonance angiography; Posterior reversible encephalopathy syndrome (PRES); Reversible cerebral vasoconstriction syndrome (RCVS)