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Published on: April 21, 2017
A pediatric case of reversible segmental cerebral vasoconstriction
Adam Kirton1, John Diggle, William Hu
1Department of Pediatrics, Division of Pediatric Neurology, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
Summary
Reversible segmental cerebral vasoconstriction (RSCV) is a syndrome presenting as thunderclap headache in children. Prompt diagnosis and angiography are key, as symptoms can resolve rapidly.
Area of Science:
- Pediatric Neurology
- Vascular Neurology
- Neuroimaging
Background:
- Reversible segmental cerebral vasoconstriction (RSCV) is a clinical and radiographic syndrome characterized by thunderclap headache and reversible narrowing of cerebral arteries.
- While typically seen in adults, RSCV can occur in pediatric populations.
Observation:
- A 13-year-old boy presented with recurrent, severe thunderclap headaches after swimming.
- Initial investigations including CT, MRI/MRA/MRV, and vasculitic work-up were normal.
- Cerebral angiography revealed reversible segmental narrowing of multiple proximal cerebral arteries.
Findings:
- The patient experienced resolution of headaches within ten days.
- Repeat angiography demonstrated normalization of cerebral blood vessels.
- This case highlights the potential for rapid resolution of RSCV.
Implications:
- RSCV should be considered in the differential diagnosis of thunderclap headache in children.
- Early diagnosis may be facilitated by prompt cerebral angiography.
- Understanding the course of RSCV in children is crucial for appropriate management.
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