A Rare Case of Idiopathic Reversible Cerebral Vasoconstriction Syndrome.

Am J Case Rep

Graduate Medical Education Research Department, Northeast Georgia Medical Center, Gainesville, GA, USA.

Published: September 2024

AI Article Synopsis

  • Reversible cerebral vasoconstriction syndrome (RCVS) is a rare condition characterized by narrowing of cerebral arteries and can lead to serious complications like seizures and strokes, commonly presenting with a severe "thunder-clap" headache.
  • A case study revealed a 34-year-old woman who visited the Emergency Department multiple times for severe headaches, ultimately being diagnosed with RCVS after suffering seizures and a brain hemorrhage during her hospitalization.
  • RCVS can often be mistaken for other similar conditions, so it's crucial for healthcare providers to recognize the symptoms and complications associated with it, ensuring timely diagnosis to prevent further health issues, especially when initial scans appear normal.

Article Abstract

BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a rare disease that is classified as a condition of diffuse cerebral artery constriction. RCVS can be complicated with transient neurological deficits, seizures, ischemic strokes, and hemorrhagic strokes. A thunder-clap headache, described as being the worst headache a patient can experience, is the predominant symptom in RCVS, which contributes to why RCVS is underdiagnosed as an ischemic stroke or migraine. CASE REPORT In this case study, we present a healthy 34-year-old Black woman who presented to the Emergency Department 3 times over a period of 4 days with concerns of severe headaches. In her first Emergency Department visit, she had a normal computed tomography scan of the brain. Her third Emergency Department visit resulted in hospitalization due to seizures, and a computed tomography brain scan done then showed acute intracranial hemorrhaging. The patient ultimately received a diagnosis of RCVS during her hospitalization. CONCLUSIONS RCVS is the most notable mimicker of other similar-presenting vasculopathies, such as primary angiitis of the central nervous system and posterior reversible encephalopathy syndrome. It is important to note that thunder-clap headache, as well as complications such as intracranial hemorrhaging and seizures, can arise not just from other diseases but from RCVS as well; hence, an early diagnosis is critical to avoid complications, especially if initial imaging is negative.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421186PMC
http://dx.doi.org/10.12659/AJCR.944273DOI Listing

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