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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

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Published on: July 21, 2013

Reversible cerebral vasoconstriction syndrome.

¹Emergency Headache Centre, Head and Neck Clinic, Lariboisière Hospital, Paris, France. anne.ducros@lrb.aphp.fr

The Lancet. Neurology

|September 22, 2012

Summary

Reversible cerebral vasoconstriction syndrome (RCVS) causes severe headaches and artery constriction, often occurring postpartum or after drug use. Prompt diagnosis and management are crucial for preventing stroke complications.

Area of Science:

Neurology
Vascular Neurology

Background:

Reversible cerebral vasoconstriction syndrome (RCVS) is an increasingly recognized neurological condition.
It is characterized by severe headaches and segmental constriction of cerebral arteries, typically resolving within 3 months.

Purpose of the Study:

To summarize the clinical presentation, pathophysiology, and diagnostic challenges of RCVS.
To highlight the dynamic nature of RCVS manifestations and the importance of timely diagnosis.

Main Methods:

Review of clinical data and neuroimaging findings in patients with RCVS.
Analysis of the temporal relationship between clinical onset, imaging, and angiographic features.

Main Results:

RCVS can manifest with thunderclap headaches, seizures, strokes, and subarachnoid hemorrhage.

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The syndrome is often associated with postpartum status or exposure to adrenergic/serotonergic drugs.

Cerebral vasoconstriction peaks 2-3 weeks after symptom onset, complicating early diagnosis.

Conclusions:

RCVS diagnosis can be challenging due to dynamic clinicoradiological features.
While nimodipine may alleviate headaches, its effect on preventing stroke complications in RCVS is unproven.