Reversible Cerebral Vasoconstriction Syndrome Associated With Fluoxetine

Manning, Tessa; Bartow, Christine; Dunlap, Michael R.; Kiehl, Robin Rainey; Kneale, Hilary; Walker, Ashley E.

doi:10.1016/j.jaclp.2021.07.013

Cited by 8 publications

(9 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RCVS can occur spontaneously/idiopathically, without a precipitating factor; in other patients, it occurs secondarily (approximately 40-60% of cases) [1,46]. The precipitating factors and triggers of RCVS and TCH, respectively, are manifold (Table 4), which illustrates why the exact pathophysiology is not yet fully understood [11,12,17,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. Trigger factors for the most severe headache in a patient's life can include coughing, bathing, physical exertion, Valsalva maneuvers, and sexual activity [55,[62][63][64][65].…”

Section: Risk Factors and Triggersmentioning

confidence: 99%

RCVS: by clinicians for clinicians—a narrative review

2022

View full text Add to dashboard Cite

Background/Objective Reversible cerebral vasoconstriction syndrome may be underdiagnosed. It can be accompanied by various complications, mainly intracerebral hemorrhage and ischemic stroke. The clinical presentation of this condition varies according to its localization. The aims of this review are to raise awareness of the disease, especially in the presence of corresponding risk factors; to connect its precipitating factors, pathophysiology, and complications; and to compare various differential diagnoses of vasoconstriction. Methods A review of the literature in PubMed/MEDLINE and Google Scholar was conducted from May 1997 until May 2022. Results Reversible cerebral vasoconstriction syndrome, which is a clinical–radiological syndrome, is mainly characterized by the occurrence of thunderclap headache and widespread vasoconstriction. The most common precipitating factors are the use of vasoactive substances and postpartum status. The pathophysiology is currently assumed to include two mechanisms: sympathetic overactivity and endothelial dysfunction. From these mechanisms, it is possible to derive potential complications as well as the most important differential diagnoses: posterior reversible encephalopathy syndrome, convexity subarachnoid hemorrhage, ischemic and hemorrhagic stroke, and primary angiitis of the central nervous system. Conclusion In general, the outcome of reversible cerebral vasoconstriction syndrome is very good. Vasospasm as well as thunderclap headache attacks can be fully reversible, and > 90% of patients are functionally independent at discharge.

show abstract

Section: Risk Factors and Triggersmentioning

confidence: 99%

RCVS: by clinicians for clinicians—a narrative review

2022

View full text Add to dashboard Cite

show abstract

“…Although the cause of RCVS is not yet fully detailed in the literature, most studies point to a transient dysregulation in the control of brain vessel tone, which results in multifocal vasoconstriction [ 46 , 57 ]. It is known that the control of vascular tone can be affected by several biochemical and immunological factors [ 2 , 58 – 60 ], among which, in scientific evidence, endothelial dysfunction and sympathetic hyperstimulation stand out [ 3 , 10 , 13 , 19 , 20 , 39 , 61 , 62 ] and alteration of vascular smooth muscle by oxidative stress [ 13 , 19 , 20 , 39 , 61 , 63 ]. In addition, genetic predispositions such as Brain-Derived Neurotrophic Factor gene polymorphism [ 58 ] are also described and seem to be associated with more severe clinical conditions [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reversible Cerebral Vasoconstriction Syndrome diagnosis is based on compatible clinical history, physical examination, and neuroimaging tests showing multifocal segmental vasoconstriction of cerebral arteries. Within 3 months, reversibility of this vasoconstriction occurs, evidenced in neuroimaging, however, some patients may persist with clinical deficits as well as complications, such as ischemic lesions and cerebral hemorrhage [ 9 , 16 , 17 , 48 , 62 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although there is still no universal diagnostic criterion established [ 16 , 17 , 62 ], some studies describe the use of scores for the diagnosis of RCVS. For example, the RCVS2 score uses clinical and imaging information to make a differential diagnosis with other arteriopathies [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there are still reports of recurrence of RCVS [ 17 , 30 , 32 , 62 , 83 ], with associated factors like the history of migraine [ 25 ] and physical exercise as a triggering factor for thunderclap headache in the first episode of RCVS [ 32 ]. Therefore, for a good prognosis and a lower chance of recurrence, avoiding the use of vasoactive substances that interfere with the clinical management of RCVS, such as adrenergic and serotonergic drugs, may be effective [ 84 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Reversible cerebral vasoconstriction syndrome: literature review

Ribas

Paticcié

Medeiros³

et al. 2023

Egypt J Neurol Psychiatry Neurosurg

View full text Add to dashboard Cite

Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a neurovascular condition characterized by a severe sudden-onset headache that may be associated with focal neurological deficits. On imaging, the suggestive finding corresponds to multifocal vasoconstriction of the cerebral arteries, with a spontaneous resolution of approximately 12 weeks. The identification of precipitating factors and diagnosis must be carried out early, so that adequate management is established and the patient has a good prognosis, given the risk of secondary complications and residual neurological deficits. This study consists of a literature review based on the analysis of articles published between 2017 and 2022 in PubMed, SciELO, and ScienceDirect on RCVS, intending to understand the clinical and radiological characteristics, diagnosis, treatment, and prognosis of patients with RCVS. The pathophysiology, drug management, and prognosis still lack solid evidence; therefore, further studies on RCVS are needed to expand medical knowledge and avoid underdiagnosis and inadequate treatment of this important condition.

show abstract

Fluoxetine

2021

Reactions Weekly

View full text Add to dashboard Cite

Reversible Cerebral Vasoconstriction Syndrome Associated With Fluoxetine

Cited by 8 publications

References 44 publications

RCVS: by clinicians for clinicians—a narrative review

RCVS: by clinicians for clinicians—a narrative review

Reversible cerebral vasoconstriction syndrome: literature review

Fluoxetine

Contact Info

Product

Resources

About