Clinical manifestations and pathogenesis of reversible cerebral vasoconstriction syndrome
https://doi.org/10.33667/2078-5631-2020-22-22-26
Abstract
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.
About the Authors
M. Yu. Afanasyeva
North-Western State Medical University n.a. I.I. Mechnikov
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
V. V. Goldobin
North-Western State Medical University n.a. I.I. Mechnikov
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
E. G. Klocheva
North-Western State Medical University n.a. I.I. Mechnikov
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
References
1. Ducros A. Reversible cerebral vasoconstriction syndrome: distinction from CNS vasculitis // Presse Med. 2013; 42: 602.
2. Henry P. Y., Larre P., Aupy M. et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives // Cephalalgia. 1984; 4: 171.
3. Snider BD, McClelland RR. Isolated benign cerebral vasculitis. // Arch Neurol. 1978; 35: 612–14.
4. Serdaru M, Shiras J, Cujas M. et.al. Isolated benign cerebral vasculitis or migrainous vasospasm? // J Neurol Neurosurg Psychiatry. 1984; 47: 73–76.
5. Rousseaux P, Sherpereel B, Bernard MH. et al. Acute benign cerebral angiopathy: 6 cases. // Press med. 1983; 2163–2168.
6. Call GK, Fleming MC, Sealfon S. et al. Reversible cerebral segmental vasoconstriction. // Stroke. 1988; 19: 1159–1170.
7. Calabrese LH, Dodick DW, Schwedt TJ. et al. Narrative review: reversible cerebral vasoconstriction syndromes. // Ann Intern Med. 2007; 146: 34–44.
8. 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.
9. 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.
10. 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.
11. Sheikh HU, Mathew PG. Reversible cerebral vasoconstriction syndrome: updates and new perspectives. // Curr Pain Headache Rep. 2014; 18: 414.
12. 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.
13. 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.
14. 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.
15. 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.
16. Kirton A, Diggle J, Hu W, et al. A pediatric case of reversible segmental cerebral vasoconstriction. // Can J Neurol Sci. 2006; 33: 250–53.
17. Liu HY, Fuh JL, Lirng JF, et al. Three paediatric patients with reversible cerebral vasoconstriction syndromes. // Cephalalgia. 2010; 30: 354–59.
18. Probert R, Saunders DE, Ganesan V. Reversible cerebral vasoconstriction syndrome: rare or underrecognized in children? // Dev Med Child Neurol. 2013; 55: 385–89.
19. Singhal AB, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndrome: analysis of 139 of cases. // Arch Neurol. 2011; 68: 1005–1012.
20. Chen SP, Fuh JL, Wang SJ. Reversible cerebral vasoconstriction syndrome: current and future perspectives. // Exp Rv Neurother. 2011; 11 (9): 1265–1276.
21. Ducros A. Reversible cerebral vasoconstriction syndrome. // Lancet Neurol. 2012; 11: 906–917.
22. Palma JA, Fontes-Villalba A, Irimia P, et al. Reversible cerebral vasoconstriction syndrome induced by adrenaline. // Cephalalgia. 2012; 32: 500.
23. Soo Y, Singhal AB, Leung T, et al. Reversible cerebral vasoconstriction syndrome with posterior leucoencephalopathy after oral contraceptive pills. // Cephalalgia. 2010; 30: 42–45.
24. Raroque HG Jr, Tesfa G, Purdy P. Postpartum cerebral angiopathy. Is there a role for sympathomimetic drugs? // Stroke. 1993; 24: 2108.
25. Henry PY, Larre P, Aupy M, et al. Reversible cerebral arteriopathy associated with the administration of ergot derivatives. // Cephalalgia. 1984; 4: 171.
26. Topcuoglu MA, Kursun O, Singhal AB. Coexisting vascular lesions in reversible cerebral vasoconstriction syndrome. // Cephalalgia. 2017; 37: 29.
27. Mawet J, Boukobza M, Franc J, et al. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. // Neurology. 2013; 81: 821.
28. Field DK, Kleinig TJ, Thompson PD, Kimber TE. Reversible cerebral vasoconstriction, internal carotid artery dissection and renal artery stenosis. // Cephalalgia. 2010; 30: 983.
29. Hiraga A, Aotsuka Y, Koide K, Kuwabara S. Reversible cerebral vasoconstriction syndrome precipitated by airplane descent: Case report. // Cephalalgia. 2017; 37: 1102.
30. Calic Z, Choong H, Schlaphoff G, Cappelen-Smith C. Reversible cerebral vasoconstriction syndrome following indomethacin. // Cephalalgia. 2014; 34: 1181.
31. Marra A, Vargas M, Striano P, et al. Posterior reversible encephalopathy syndrome: the endothelial hypotheses. // Med Hypotheses. 2014; 82: 619–22.
32. Santos L., Azevedo E. Reversible cerebral vasoconstriction syndrome – A narrative revision of the literature. // Porto Biomed. J. 2016; 1 (2): 65–71.
33. 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.
34. Ducros A., Wolff V. The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers. // Headache. 2016; 56: 657–673.
35. Chen SP, Wang SJ. Hyperintense vessels: an early MRI marker of reversible cerebral vasoconstriction syndrome? // Cephalalgia. 2014; 34: 1038–39.
Review
For citations:
Afanasyeva M.Yu., Goldobin V.V., Klocheva E.G. Clinical manifestations and pathogenesis of reversible cerebral vasoconstriction syndrome. Medical alphabet. 2020;(22):22-26. (In Russ.) https://doi.org/10.33667/2078-5631-2020-22-22-26
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