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Permanent Cerebral Vessel Occlusion via Double Ligature and Transection
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Reversible cerebral vasoconstriction syndrome.

Anne Ducros1

  • 1Department of Neurology, Hôpital Gui de Chauliac, Montpellier, France.

Handbook of Clinical Neurology
|December 25, 2013
PubMed
Summary

Reversible cerebral vasoconstriction syndrome causes severe headaches and can lead to stroke. This condition involves temporary narrowing of brain arteries, often triggered by substances or postpartum, and typically resolves within three months.

Keywords:
Reversible cerebral vasoconstriction syndromeangiographystrokethunderclap headachevasospasm

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Area of Science:

  • Neurology
  • Vascular Neurology

Background:

  • Reversible cerebral vasoconstriction syndrome (RCVS) is a condition causing severe headaches and temporary narrowing of cerebral arteries.
  • It is increasingly recognized and linked to sympathetic overactivity, potentially causing stroke, particularly in young individuals.

Purpose of the Study:

  • To describe the characteristics, triggers, clinical course, and diagnostic challenges of RCVS.
  • To review current understanding of its pathophysiology and treatment.

Main Methods:

  • Review of clinical manifestations, diagnostic imaging (angiography), and outcomes in RCVS patients.
  • Analysis of potential triggers such as vasoactive substances and postpartum state.

Main Results:

  • RCVS presents with thunderclap headaches, focal deficits, or seizures, with arterial narrowing resolving within 3 months.
  • Onset often occurs postpartum or after exposure to vasoactive substances, predominantly affecting middle-aged women.
  • Diagnosis can be challenging due to dynamic clinicoradiological features, with complications like stroke or hemorrhage occurring days after initial imaging.

Conclusions:

  • RCVS is a distinct neurological syndrome with a typically monophasic course, characterized by reversible arterial constriction.
  • Early recognition and removal of triggers are crucial; symptomatic treatment and nimodipine may help headaches but not necessarily prevent complications.