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08:22
Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
Published on: July 21, 2013
Reversible cerebral vasoconstriction syndrome.
Pedro Augusto Sampaio Rocha Filho1, Janayna Santos Barbosa, Ana Rosa Melo Correa-Lima
1Hospital Universitario Oswaldo Cruz, University of Pernambuco, Recife, Brazil. pasrf@ig.com.br
Revista Medica De Chile
|December 9, 2010
Summary
Reversible cerebral vasoconstriction syndrome can cause thunderclap headaches. Early investigation is crucial for patients with normal CT and CSF, even with recurrent headaches.
Area of Science:
- Neurology
- Vascular Neurology
Background:
- Reversible cerebral vasoconstriction syndrome (RCVS) presents with thunderclap headache and multifocal cerebral artery vasoconstriction.
- Vasoconstriction typically resolves within three months.
- RCVS diagnosis excludes aneurysmal subarachnoid hemorrhage.
Observation:
- A 44-year-old man experienced recurrent thunderclap headaches, one during sexual intercourse and another at rest.
- Initial neurological examination and brain CT were normal.
- Cerebrospinal fluid analysis revealed mild pleocytosis and red blood cells, with subsequent normalization.
Findings:
- Digital cerebral angiography initially showed diffuse segmental intracerebral vasospasm.
- A follow-up angiography 15 days later revealed normal cerebral arteries.
- The patient remained headache-free for 26 months post-episode.
Implications:
- Thunderclap headache with normal brain CT and CSF warrants investigation for RCVS.
- Early diagnosis and management of RCVS can prevent recurrent episodes.
- This case highlights the importance of considering RCVS in patients with unexplained thunderclap headaches.
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