medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2020-22-22-26medalphabet-1676Research ArticleСтатьиКлинические проявления, факторы риска и церебральные ангиодисплазии при синдроме обратимой церебральной вазоконстрикцииClinical manifestations and pathogenesis of reversible cerebral vasoconstriction syndromeАфанасьеваМ. Ю.AfanasyevaM. Yu.

Аспирант кафедры

Кафедра неврологии имени академика С.Н. Давиденкова

Санкт-Петербург

 

ГолдобинВ. В.GoldobinV. V.

Доктор медицинских наук, доцент кафедры

Кафедра неврологии имени академика С.Н. Давиденкова

Санкт-Петербург

КлочеваЕ. Г.KlochevaE. G.

Доктор медицинских наук, профессор кафедры

Кафедра неврологии имени академика С.Н. Давиденкова

Санкт-Петербург

ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава РоссииРоссияNorth-Western State Medical University n.a. I.I. MechnikovRussian Federation202020102020022Неврология и психиатрия (3)2226Copyright © Афанасьева М.Ю., Голдобин В.В., Клочева Е.Г., 20202020Афанасьева М.Ю., Голдобин В.В., Клочева Е.Г.Afanasyeva M.Y., Goldobin V.V., Klocheva E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/1676

Представлены данные пациентов с синдромом обратимой церебральной вазоконстрикции (СОЦВ), проходивших обследование и лечение в 2013– 2020 годах. Были обследованы 136 пациентов (37,3 ± 11,4 года): 107 (78,7%) женщин, 29 (21,3%) мужчин. Пациентам проводились подробное клинико-неврологическое обследование, магнитно-резонансная томография головного мозга, магнитно-резонансная ангиография, магнитно-резонансная венография. Результаты. Первичный СОЦВ был выявлен у 29 (21,3%), вторичный СОЦВ – у 69 (50,7%) пациентов, комбинация факторов первичного и вторичного СОЦВ – у 38 (28,0%) пациентов. У 95 (69,8%) обследуемых были выявлены признаки ангиодисплазии церебральных артерий (80 женщин, 15 мужчин; р < 0,05). Гипоплазия венозных синусов (поперечного и [или] сигмовидного) была обнаружена у 34 обследуемых (29 женщин и 5 мужчин). Выводы. СОЦВ у женщин развивается чаще, чем у мужчин, однако достоверного различия факторов риска у мужчин и женщин выявлено не было. У пациентов с СОЦВ одновременно могут выявляться предрасполагающие факторы как первичного, так и вторичного варианта. У женщин чаще выявлялись варианты развития брахиоцефальных артерий. Уточнение влияния вариантов ангиодисплазий на развитие и тяжесть течения СОЦВ требует дальнейшего изучения.

The data of patients with reversible cerebral vasoconstriction syndrome (RCVS) who were examined and treated in 2013–2020 are presented. 136 patients were examined (37.3 ± 11.4 years) – 107 (78.7 %) women, 29 (21.3 %) men. Detailed neurological examination, magnetic resonance imaging of the brain, magnetic resonance angiography and magnetic resonance venography were performed. Results. Primary RCVS was detected in 29 (21.3%), secondary RCVS – in 69 patients (50.7%), and a combination of primary and secondary RCVS factors – in 38 (28.0%) patients. In 95 (69.8%) patients (80 women, 15 men; p < 0.05) signs of cerebral artery angiodysplasia were identified. Hypoplasia of venous sinuses (transverse and/or sigmoid) was found in 34 patients (29 women and 5 men). Conclusions. RCVS is developed in women more often than men, but there was no significant difference in risk factors between men and women. Predisposing factors of both primary and secondary RCVS can be revealed simultaneously. Women were more likely to have variants of brachiocephalic artery development. Clarification of angiodysplasia variant influence to the development and severity of RCVS requires further study.

синдром обратимой церебральной вазоконстрикциигромоподобная головная больreversible cerebral vasoconstriction syndromethunderclap headacheReferencesDucros A. Reversible cerebral vasoconstriction syndrome: distinction from CNS vasculitis // Presse Med. 2013; 42: 602.Ducros A. Reversible cerebral vasoconstriction syndrome: distinction from CNS vasculitis // Presse Med. 2013; 42: 602.Henry P. Y., Larre P., Aupy M. et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives // Cephalalgia. 1984; 4: 171.Henry P. Y., Larre P., Aupy M. et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives // Cephalalgia. 1984; 4: 171.Snider BD, McClelland RR. Isolated benign cerebral vasculitis. // Arch Neurol. 1978; 35: 612–14.Snider BD, McClelland RR. Isolated benign cerebral vasculitis. // Arch Neurol. 1978; 35: 612–14.Serdaru M, Shiras J, Cujas M. et.al. Isolated benign cerebral vasculitis or migrainous vasospasm? // J Neurol Neurosurg Psychiatry. 1984; 47: 73–76.Serdaru M, Shiras J, Cujas M. et.al. Isolated benign cerebral vasculitis or migrainous vasospasm? // J Neurol Neurosurg Psychiatry. 1984; 47: 73–76.Rousseaux P, Sherpereel B, Bernard MH. et al. Acute benign cerebral angiopathy: 6 cases. // Press med. 1983; 2163–2168.Rousseaux P, Sherpereel B, Bernard MH. et al. Acute benign cerebral angiopathy: 6 cases. // Press med. 1983; 2163–2168.Call GK, Fleming MC, Sealfon S. et al. Reversible cerebral segmental vasoconstriction. // Stroke. 1988; 19: 1159–1170.Call GK, Fleming MC, Sealfon S. et al. Reversible cerebral segmental vasoconstriction. // Stroke. 1988; 19: 1159–1170.Calabrese LH, Dodick DW, Schwedt TJ. et al. Narrative review: reversible cerebral vasoconstriction syndromes. // Ann Intern Med. 2007; 146: 34–44.Calabrese LH, Dodick DW, Schwedt TJ. et al. Narrative review: reversible cerebral vasoconstriction syndromes. // Ann Intern Med. 2007; 146: 34–44.Ducros A, Boukobza M, Porcher R, et al. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. // Brain. 2007; 130: 3091–3101.Ducros A, Boukobza M, Porcher R, et al. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. // Brain. 2007; 130: 3091–3101.Kim T, Ahn S, Sohn CH. et.al. Reversible cerebral vasoconstriction syndrome at the emergency department. // Clin Exp Emerg Med. 2015; 2 (4): 203–209.Kim T, Ahn S, Sohn CH. et.al. Reversible cerebral vasoconstriction syndrome at the emergency department. // Clin Exp Emerg Med. 2015; 2 (4): 203–209.Koopman K, Uyttenboogaart M, Luijckx GJ, et al. Pitfalls in the diagnosis of reversible cerebral vasoconstriction syndrome and primary angiitis of the central nervous system. // Eur J Neurol. 2007; 14: 1085–87.Koopman K, Uyttenboogaart M, Luijckx GJ, et al. Pitfalls in the diagnosis of reversible cerebral vasoconstriction syndrome and primary angiitis of the central nervous system. // Eur J Neurol. 2007; 14: 1085–87.Sheikh HU, Mathew PG. Reversible cerebral vasoconstriction syndrome: updates and new perspectives. // Curr Pain Headache Rep. 2014; 18: 414.Sheikh HU, Mathew PG. Reversible cerebral vasoconstriction syndrome: updates and new perspectives. // Curr Pain Headache Rep. 2014; 18: 414.Chen S.P., Fuh J. L., Wang S. J., et al. Brain-derived neurotrophic factor gene Val66Met polymorphism modulates reversible cerebral vasoconstriction syndromes. // PLoS One. 2011; 6: e18024.Chen S.P., Fuh J. L., Wang S. J., et al. Brain-derived neurotrophic factor gene Val66Met polymorphism modulates reversible cerebral vasoconstriction syndromes. // PLoS One. 2011; 6: e18024.Liao Y.C., Fuh J. L., Lirng J. F. et al. Bathing headache: a variant of idiopathic thunderclap headache. // Cephalalgia. 2003; 23 (9): 854–859.Liao Y.C., Fuh J. L., Lirng J. F. et al. Bathing headache: a variant of idiopathic thunderclap headache. // Cephalalgia. 2003; 23 (9): 854–859.Bain J, Segal D, Amin R, et al. Call-Fleming syndrome: headache in a 16-year-old girl. // Pediatr Neurol. 2013; 49: 130–33.e1.Bain J, Segal D, Amin R, et al. Call-Fleming syndrome: headache in a 16-year-old girl. // Pediatr Neurol. 2013; 49: 130–33.e1.Hajj-Ali RA, Furlan A, Abou-Chebel A, et al. Benign angiopathy of the central nervous system: cohort of 16 patients with clinical course and long-term follow up. // Arthritis Rheum. 2002; 47: 662–69.Hajj-Ali RA, Furlan A, Abou-Chebel A, et al. Benign angiopathy of the central nervous system: cohort of 16 patients with clinical course and long-term follow up. // Arthritis Rheum. 2002; 47: 662–69.Kirton A, Diggle J, Hu W, et al. A pediatric case of reversible segmental cerebral vasoconstriction. // Can J Neurol Sci. 2006; 33: 250–53.Kirton A, Diggle J, Hu W, et al. A pediatric case of reversible segmental cerebral vasoconstriction. // Can J Neurol Sci. 2006; 33: 250–53.Liu HY, Fuh JL, Lirng JF, et al. Three paediatric patients with reversible cerebral vasoconstriction syndromes. // Cephalalgia. 2010; 30: 354–59.Liu HY, Fuh JL, Lirng JF, et al. Three paediatric patients with reversible cerebral vasoconstriction syndromes. // Cephalalgia. 2010; 30: 354–59.Probert R, Saunders DE, Ganesan V. Reversible cerebral vasoconstriction syndrome: rare or underrecognized in children? // Dev Med Child Neurol. 2013; 55: 385–89.Probert R, Saunders DE, Ganesan V. Reversible cerebral vasoconstriction syndrome: rare or underrecognized in children? // Dev Med Child Neurol. 2013; 55: 385–89.Singhal AB, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndrome: analysis of 139 of cases. // Arch Neurol. 2011; 68: 1005–1012.Singhal AB, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndrome: analysis of 139 of cases. // Arch Neurol. 2011; 68: 1005–1012.Chen SP, Fuh JL, Wang SJ. Reversible cerebral vasoconstriction syndrome: current and future perspectives. // Exp Rv Neurother. 2011; 11 (9): 1265–1276.Chen SP, Fuh JL, Wang SJ. Reversible cerebral vasoconstriction syndrome: current and future perspectives. // Exp Rv Neurother. 2011; 11 (9): 1265–1276.Ducros A. Reversible cerebral vasoconstriction syndrome. // Lancet Neurol. 2012; 11: 906–917.Ducros A. Reversible cerebral vasoconstriction syndrome. // Lancet Neurol. 2012; 11: 906–917.Palma JA, Fontes-Villalba A, Irimia P, et al. Reversible cerebral vasoconstriction syndrome induced by adrenaline. // Cephalalgia. 2012; 32: 500.Palma JA, Fontes-Villalba A, Irimia P, et al. Reversible cerebral vasoconstriction syndrome induced by adrenaline. // Cephalalgia. 2012; 32: 500.Soo Y, Singhal AB, Leung T, et al. Reversible cerebral vasoconstriction syndrome with posterior leucoencephalopathy after oral contraceptive pills. // Cephalalgia. 2010; 30: 42–45.Soo Y, Singhal AB, Leung T, et al. Reversible cerebral vasoconstriction syndrome with posterior leucoencephalopathy after oral contraceptive pills. // Cephalalgia. 2010; 30: 42–45.Raroque HG Jr, Tesfa G, Purdy P. Postpartum cerebral angiopathy. Is there a role for sympathomimetic drugs? // Stroke. 1993; 24: 2108.Raroque HG Jr, Tesfa G, Purdy P. Postpartum cerebral angiopathy. Is there a role for sympathomimetic drugs? // Stroke. 1993; 24: 2108.Henry PY, Larre P, Aupy M, et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives. // Cephalalgia. 1984; 4: 171.Henry PY, Larre P, Aupy M, et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives. // Cephalalgia. 1984; 4: 171.Topcuoglu MA, Kursun O, Singhal AB. Coexisting vascular lesions in reversible cerebral vasoconstriction syndrome. // Cephalalgia. 2017; 37: 29.Topcuoglu MA, Kursun O, Singhal AB. Coexisting vascular lesions in reversible cerebral vasoconstriction syndrome. // Cephalalgia. 2017; 37: 29.Mawet J, Boukobza M, Franc J, et al. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. // Neurology. 2013; 81: 821.Mawet J, Boukobza M, Franc J, et al. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. // Neurology. 2013; 81: 821.Field DK, Kleinig TJ, Thompson PD, Kimber TE. Reversible cerebral vasoconstriction, internal carotid artery dissection and renal artery stenosis. // Cephalalgia. 2010; 30: 983.Field DK, Kleinig TJ, Thompson PD, Kimber TE. Reversible cerebral vasoconstriction, internal carotid artery dissection and renal artery stenosis. // Cephalalgia. 2010; 30: 983.Hiraga A, Aotsuka Y, Koide K, Kuwabara S. Reversible cerebral vasoconstriction syndrome precipitated by airplane descent: Case report. // Cephalalgia. 2017; 37: 1102.Hiraga A, Aotsuka Y, Koide K, Kuwabara S. Reversible cerebral vasoconstriction syndrome precipitated by airplane descent: Case report. // Cephalalgia. 2017; 37: 1102.Calic Z, Choong H, Schlaphoff G, Cappelen-Smith C. Reversible cerebral vasoconstriction syndrome following indomethacin. // Cephalalgia. 2014; 34: 1181.Calic Z, Choong H, Schlaphoff G, Cappelen-Smith C. Reversible cerebral vasoconstriction syndrome following indomethacin. // Cephalalgia. 2014; 34: 1181.Marra A, Vargas M, Striano P, et al. Posterior reversible encephalopathy syndrome: the endothelial hypotheses. // Med Hypotheses. 2014; 82: 619–22.Marra A, Vargas M, Striano P, et al. Posterior reversible encephalopathy syndrome: the endothelial hypotheses. // Med Hypotheses. 2014; 82: 619–22.Santos L., Azevedo E. Reversible cerebral vasoconstriction syndrome – A narrative revision of the literature. // Porto Biomed. J. 2016; 1 (2): 65–71.Santos L., Azevedo E. Reversible cerebral vasoconstriction syndrome – A narrative revision of the literature. // Porto Biomed. J. 2016; 1 (2): 65–71.Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vaso-constriction syndrome, Part 2: diagnostic work-up, imaging evaluation, and differential diagnosis. // AJNR Am J Neuroradiol. 2015; 36: 1580–8.53.Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vaso-constriction syndrome, Part 2: diagnostic work-up, imaging evaluation, and differential diagnosis. // AJNR Am J Neuroradiol. 2015; 36: 1580–8.53.Ducros A., Wolff V. The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers. // Headache. 2016; 56: 657–673.Ducros A., Wolff V. The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers. // Headache. 2016; 56: 657–673.Chen SP, Wang SJ. Hyperintense vessels: an early MRI marker of reversible cerebral vasoconstriction syndrome? // Cephalalgia. 2014; 34: 1038–39.Chen SP, Wang SJ. Hyperintense vessels: an early MRI marker of reversible cerebral vasoconstriction syndrome? // Cephalalgia. 2014; 34: 1038–39.

The authors declare that there are no conflicts of interest present.