J Neurointensive Care.  2021 Apr;4(1):42-46. 10.32587/jnic.2021.00360.

Hemorrhagic Reversible Cerebral Vasoconstriction Syndrome: Clinical Presentation, Differential Diagnosis, Mechanism, and Treatment

• Park SH
• Lee SH
• Park KJ
• Kang SH
• Park DH

• KMID: 2555049
• DOI: http://doi.org/10.32587/jnic.2021.00360

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical and radiologic syndrome that presents with a severe headache associated with multifocal segmental vasoconstriction of the cerebral arteries. The pathophysiology of RCVS is unknown, but changes in arterial tone seem to a key mechanism. The clinical course of RCVS is self-limiting, resolving spontaneously. RCVS usually follows a benign course, but the prognosis can vary because delayed intracerebral hemorrhage, ischemic, or hemorrhagic stroke can occur. Computed tomography angiography and digital subtraction angiography are the diagnostic methods of choice. The calcium channel blocker and analgesic agent, nimodipine, seems to reduce the severity of the headaches. This case report characterized the clinical presentation, diagnosis, differential diagnosis, clinical course, and management of RCVS to assist with differentiating it from other conditions it may be confused with.

Keyword

Reversible cerebral vasoconstriction syndrome; Primary reversible cerebral vasoconstriction syndrome; primary angiitis of the central nervous system