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'Diagnostic anchoring' and a delayed diagnosis of reversible cerebral vasoconstriction syndrome

Shiwei Huang1, Cameron Williams1, James Thomas2

  • 1Department of Interventional Radiology, Liverpool Hospital, Liverpool, New South Wales, Australia.

BMJ Case Reports
|May 15, 2023
PubMed

We present a case of a woman in her 60s with acute left hemispheric ischaemic stroke syndrome due to tandem occlusions of the proximal left internal carotid artery and left middle cerebral artery. This was treated with emergent carotid artery stenting and endovascular clot retrieval. The patient made a complete recovery and was discharged home only to represent a few days later with focal neurological symptoms, profound headache and labile blood pressure. The diagnostic and management challenges of reversible cerebral vasoconstriction syndrome, including imaging assessment and the importance of avoiding 'diagnostic anchoring' are discussed.

Keywords:
Headache (including migraines)Interventional radiologyNeuroimagingRadiologyStroke

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