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Reversible Cerebral Vasoconstriction Syndrome Following a Steroid Burst: A Case Report
Jacob Lenning1, Caleb Halfill1, Justin Rountree1
1Western Michigan University Homer Stryker M.D. School of Medicine, Department of Emergency Medicine, Kalamazoo, Michigan.
Introduction:
Reversible cerebral vasoconstriction syndrome is a recently defined disease entity classically presenting with recurrent thunderclap headache. The pathology involves triggered cerebral arterial vasoconstriction, which can lead to complications including seizure, ischemic stroke, and intracranial hemorrhage. Diagnosis requires angiography, and treatment consists of vasodilatory therapy.
Case Report:
We describe a case of reversible cerebral vasoconstriction syndrome following glucocorticoid burst therapy in a patient on multiple vasoactive medications, suggesting the possibility of compounding risk factors and triggers. As is common with this syndrome, the patient in our case required multiple hospital visits for diagnosis but ultimately experienced a positive outcome upon treatment.
Conclusion:
The presentation of reversible cerebral vasoconstriction syndrome can vary. Diagnosis requires a high degree of suspicion in patients with potential triggers to ensure early treatment and avoidance of poor outcomes.
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