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Reversible Cerebral Vasoconstriction Syndrome Presenting With Visual Field Defects.
Meisha L Raven1, Alexander L Ringeisen, Angela R McAllister
1Department of Ophthalmology and Visual Sciences, University of Wisconsin (MLR, ALR, DWK), Madison, WI; and Essentia Health (ARM), Ophthalmology, Duluth, MN.
Summary
A rare condition called reversible cerebral vasoconstriction syndrome caused severe headaches and vision changes in a woman. Prompt diagnosis and treatment led to symptom resolution and favorable outcomes.
Area of Science:
- Neurology
- Vascular Neurology
Background:
- Selective serotonin reuptake inhibitors (SSRIs) are commonly used for depression and anxiety.
- Reversible cerebral vasoconstriction syndrome (RCVS) is a rare neurological disorder characterized by temporary narrowing of brain arteries.
Observation:
- A 45-year-old woman on SSRIs presented with severe bifrontal headaches, left homonymous hemianopia, and altered mental status.
- Magnetic Resonance Angiography (MRA) showed segmental vasoconstriction in multiple cerebral arteries.
Findings:
- The patient's symptoms and MRA findings were consistent with RCVS.
- Treatment with a calcium-channel blocker and magnesium resulted in complete resolution of symptoms and cerebrovascular changes.
Implications:
- RCVS, though rare, often presents with visual disturbances and requires urgent diagnosis.
- Prompt management of RCVS is crucial to prevent serious complications such as stroke, seizures, and subarachnoid hemorrhage.
