Hemorrhagic Reversible Cerebral Vasoconstriction Syndrome: Clinical Presentation, Differential Diagnosis, Mechanism, and Treatment

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is typically characterized by clinically severe headache, neurologic deficits caused by ischemia or intracerebral hemorrhage, and radiologically observed multifocal cerebral artery vasoconstriction 1,2) .The purpose of this case report was to report the clinical treatment and management, as well as discuss the imaging characteristics, of an RCVS patient. CASE REPORTA 28-year-old woman with no past medical history presented Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical and radiologic syndrome that presents with a severe headache associated with multifocal segmental vasoconstriction of the cerebral arteries. The pathophysiology of RCVS is unknown, but changes in arterial tone seem to a key mechanism. The clinical course of RCVS is self-limiting, resolving spontaneously. RCVS usually follows a benign course, but the prognosis can vary because delayed intracerebral hemorrhage, ischemic, or hemorrhagic stroke can occur. Computed tomography angiography and digital subtraction angiography are the diagnostic methods of choice. The calcium channel blocker and analgesic agent, nimodipine, seems to reduce the severity of the headaches. This case report characterized the clinical presentation, diagnosis, differential diagnosis, clinical course, and management of RCVS to assist with differentiating it from other conditions it may be confused with.