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[Subdural hematoma with reversible cerebral vasoconstriction syndrome: a case report]
Genki Ikuta1, Keishi Makino1, Koutaro Takamatsu2
1Department of Neurosurgery, Kumamoto City Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|August 28, 2022
Summary
A man experienced thunderclap headaches and cervical pain, leading to the diagnosis of reversible cerebral vasoconstriction syndrome (RCVS). Treatment with a calcium-channel antagonist successfully improved his condition, confirming the RCVS diagnosis.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Persistent cervical pain and thunderclap headache during sleep can be indicative of serious neurological conditions.
- Subdural hematoma and hemorrhage require prompt diagnostic evaluation.
Observation:
- A 71-year-old male presented with persistent cervical pain and thunderclap headache during sleep.
- Initial MRI revealed subdural hematoma and convexity subdural hemorrhage in the right occipital region.
- MRA demonstrated bilateral posterior cerebral artery (PCA) narrowing, which worsened on follow-up.
Findings:
- The clinical presentation and imaging findings were consistent with reversible cerebral vasoconstriction syndrome (RCVS).
- Aggravated PCA narrowing on follow-up MRA further supported the diagnosis of RCVS.
- The patient's condition improved following treatment with a calcium-channel antagonist.
Implications:
- This case highlights the importance of considering RCVS in patients presenting with thunderclap headaches and associated neurological findings.
- Prompt diagnosis and appropriate treatment, such as calcium-channel antagonists, are crucial for managing RCVS and preventing complications.
- The successful outcome underscores the reversible nature of the arterial changes in RCVS with timely intervention.
Keywords:
convexity subarachnoid hemorrhagereversible cerebral vasoconstriction syndrome (RCVS)subdural hematomaMore Related Videos
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