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Fulminant Reversible Cerebral Vasoconstriction Syndrome.
Kushak Suchdev1, Gregory Norris1, Imad Zak2
1Department of Neurology, Wayne State University, Detroit, MI, USA.
The Neurohospitalist
|December 26, 2017
Summary
Reversible cerebral vasoconstriction syndrome (RCVS) typically resolves without intervention. However, this case highlights a rare, fatal presentation of RCVS with rapid neurological decline, emphasizing treatment challenges.
Area of Science:
- Neurology
- Vascular Neurology
- Neurocritical Care
Background:
- Reversible cerebral vasoconstriction syndrome (RCVS) is a recognized cause of thunderclap headaches.
- RCVS commonly presents with a benign, self-limiting course.
- Rarely, RCVS can manifest with severe, rapid neurological deterioration.
Purpose of the Study:
- To report an exceptionally rare, fulminant course of RCVS.
- To illustrate the diagnostic challenges and treatment difficulties in severe RCVS cases.
Main Methods:
- Case presentation of a 25-year-old female with progressive headaches.
- Diagnostic workup including CT, CT angiography, and conventional cerebral angiography.
- Review of autopsy findings.
Main Results:
- The patient experienced rapid neurological decline with hemorrhage and ischemic strokes.
- Angiography confirmed multifocal vasoconstriction consistent with RCVS.
- Despite aggressive management, the patient had a fatal outcome.
Conclusions:
- RCVS can rarely present with a devastating, monophasic course.
- This case underscores the challenges in managing severe RCVS and highlights the need for further research into its atypical presentations.
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