scholarly journals Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Acute Severe Headache

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Li Huey Tan ◽  
Oliver Flower
Keyword(s):  
Central Nervous System ◽  
Neurological Complications ◽  
Severe Headache ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Diagnostic Features ◽  
Therapeutic Implications ◽  
Cerebral Vasoconstriction ◽  
Primary Angiitis ◽  
The Central Nervous System ◽  
Acute Headache

Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized and important cause of acute headache. The majority of these patients develop potentially serious neurological complications. Rigorous investigation is required to exclude other significant differential diagnoses. Differentiating RCVS from subarachnoid haemorrhage (SAH) and primary angiitis of the central nervous system (PACNS) may be difficult but has important therapeutic implications. This paper describes what is currently known about the epidemiology, pathophysiology, clinical, and diagnostic features of the syndrome, an approach to investigation, a summary of treatments, and what is known of prognosis.

Reversible cerebral vasoconstriction syndromes and primary angiitis of the central nervous system: clinical, imaging, and angiographic comparison

2016 ◽  
Vol 79 (6) ◽  
pp. 882-894 ◽  
Author(s):  
Aneesh B. Singhal ◽  
Mehmet A. Topcuoglu ◽  
Joshua W. Fok ◽  
Oguzhan Kursun ◽  
Raul G. Nogueira ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Imaging ◽  
Cerebral Vasoconstriction ◽  
Primary Angiitis ◽  
The Central Nervous System

scholarly journals Iatrogenic acute headache secondary to co-administration of ergometrine and phenylephrine during cesarean section: a case report

2019 ◽  
Author(s):  
Yan Mei Bi ◽  
Juan Ni
Keyword(s):  
Cesarean Section ◽  
Vital Signs ◽  
Severe Headache ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Elective Cesarean Section ◽  
Cerebral Vasoconstriction ◽  
Elective Cesarean ◽  
Acute Headache ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Background Reversible cerebral vasoconstriction syndrome has been described as a syndrome of severe recurrent thunderclap headache in bilateral posterior, with or without other neurological symptoms and signs, is fully reversible by 3 months. Vasoconstrictor play an important role in the development of reversible cerebral vasoconstriction syndrome. Case presentation A 37-year-old pregnant women underwent elective cesarean section at 36+6 weeks gestation under combined spinal-epidural anesthesia . After a healthy female neonate was delivered, 0.2mg ergometrine was injected intramuscularly to induce uterine contraction. 30 minutes later, 0.1mg phenylephrine was given intravenously to treatment hypotension. Then she complained of a sudden headache and blood pressure was significantly risen to 163/104 mmHg versus baseline was 118/76 mmHg. Her severe headache was relieved 2 hrs after administering nitroglycerin, and headache did not recur after discontinued nitroglycerin. Conclusion The reason of hypotension should be identified in patients received ergometrine during cesarean section. Phenylephrine or other sympathomimetic should be used cautiously and vital signs should be observed closely for patient who received ergometrine during cesarean section. Nitroglycerin may be an alternative for the treatment of severe headache in reversible cerebral vasoconstriction syndrome.

Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: A diagnostic tool in select cases?

Cephalalgia ◽  
2011 ◽  
Vol 31 (10) ◽  
pp. 1074-1081 ◽  
Author(s):  
J Linn ◽  
G Fesl ◽  
C Ottomeyer ◽  
A Straube ◽  
M Dichgans ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Diagnostic Tool ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Digital Subtraction ◽  
Preliminary Results ◽  
Cerebral Vasoconstriction ◽  
The Central Nervous System ◽  
Digital Subtraction Angiographic ◽  
Clinical Worsening

Introduction: Differential diagnoses of the reversible cerebral vasoconstriction syndrome (RCVS) include all forms of intracranial stenotic disease, such as primary or secondary vasculitis of the central nervous system. Here, we tested the hypothesis that angiographic response to intra-arterial nimodipine application may be helpful in differentiating between RCVS and other entities. Methods: A digital subtraction angiographic (DSA) series of nine consecutive patients with suspected RCVS that were treated by intra-arterial nimodipine due to clinical worsening were retrospectively analyzed. Pre- and post-therapeutic DSA findings of patients with later-confirmed RCVS were compared to those in which another diagnosis was finally made. Results: Intra-arterial nimodipine resulted in a normalization of both the diameter of the main trunks of the cerebral vessels and the caliber of the peripheral vessels in all RCVS patients. This was not the case in the non-RCVS patients, in whom only a slight general vasodilatation was observed. Discussion: Our preliminary results indicate that angiographic response to intra-arterial application might be a helpful differential diagnostic tool in select patients with suspected RCVS.

scholarly journals Primary angiitis of central nervous system with cephalic syndrome

2017 ◽  
Vol 95 (6) ◽  
pp. 571-575
Author(s):  
Natal’ya L. Starikova ◽  
E. V. Zalomova
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Corticosteroid Therapy ◽  
Systemic Vasculitis ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Cerebral Vasoconstriction ◽  
Primary Angiitis

A man aged 37 years experienced recurrent episodes of intensive headache. MRI revealed multiple symmetric lesions in brain. Systemic vasculitis, reversible cerebral vasoconstriction syndrome and migraine were excluded. Primary angiitis of central nervous system was diagnosed. The patient’s condition rapidly improved on corticosteroid therapy.

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