Postpartum Reversible Cerebral Vasoconstriction Syndrome Presenting with Radiological Plethora

Area of Science:

• Neurology
• Radiology

Background:

• Reversible cerebral vasoconstriction syndrome (RCVS) is a clinicoradiological condition involving cerebral artery narrowing.
• While often benign, RCVS can rarely be fatal.
• Typical presentations include TIA, IS, ICH, SAH, and PRES.

Observation:

• A postpartum woman presented with RCVS exhibiting unusual radiological findings.
• Her presentation included intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), and atypical PRES.
• The clinical presentation was also atypical, highlighting diagnostic challenges.

Findings:

• RCVS can manifest with diverse and atypical neurological symptoms and radiological features.
• The case underscores that RCVS can present with severe complications like ICH and SAH.
• Atypical PRES was also observed, broadening the spectrum of RCVS manifestations.

Implications:

• High clinical suspicion is essential for diagnosing RCVS, especially in atypical cases.
• Awareness of both typical and atypical RCVS presentations and complications is vital for clinicians.
• Prompt emergency diagnosis and management of RCVS can improve patient outcomes and reduce morbidity.