A case of reversible cerebral vasoconstriction syndrome presenting with recurrent neurological deficits: Evaluation using noninvasive arterial spin labeling MRI

Komatsu, Teppei; Kimura, Tatsuki; Yagishita, Akira; Takahashi, Katsumi; Koide, Reiji

doi:10.1016/j.clineuro.2014.08.023

Cited by 13 publications

(12 citation statements)

References 6 publications

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“…The quantitative CBF analysis using an automated ROI placement was advantageous in enabling us to more objectively evaluate chronological CBF changes using ASL and to detect new aspects in serial CBF changes in RCVS. In addition to the previously reported asymmetric cerebral hypoperfusion on visual inspection at the onset of symptoms, 2,13 this quantitative analysis demonstrated a paradoxical increase in nCBF irrespective of vasoconstriction progression from the first to second weeks. Moreover, higher nCBF increase ratios were detected in patients with both cSAH and PRES.…”

Section: Discussionsupporting

confidence: 64%

“…Arterial spin labeling (ASL), which is a noninvasive magnetic resonance imaging (MRI) technique for measuring cerebral blood flow (CBF), has reportedly been useful in a few case reports of RCVS. 2,3 However, quantitative CBF analysis using ASL has not been thoroughly evaluated. In this study, we quantified serial CBF changes using ASL to evaluate hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the use of other imaging techniques could be useful for an accurate and early diagnosis of RCVS. Arterial spin labeling (ASL), which is a noninvasive magnetic resonance imaging (MRI) technique for measuring cerebral blood flow (CBF), has reportedly been useful in a few case reports of RCVS 2,3 . However, quantitative CBF analysis using ASL has not been thoroughly evaluated.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative arterial spin labeling magnetic resonance imaging analysis of reversible cerebral vasoconstriction syndrome: A case series

et al. 2021

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Objective: This study aimed to quantify chronological cerebral blood flow (CBF) changes using arterial spin labeling (ASL) magnetic resonance imaging in patients with reversible cerebral vasoconstriction syndrome (RCVS).Background: Quantitative ASL analyses in RCVS have not been well described in the literature.Methods: Quantification of ASL using an automated region-of-interest placement software and a 5-point visual scale of vasoconstriction severity was performed in five RCVS patients. The association between CBF changes and RCVS-related complications was evaluated.Results: Quantitative ASL revealed variable patterns of decreasing CBF in the first week, followed by subsequent increases. Notably, arterial vasoconstriction paradoxically progressed despite an increase in CBF from the first to the second week; this increase was relatively higher in patients with both cortical subarachnoid hemorrhage and posterior reversible encephalopathy syndrome. Conclusions:Quantitative ASL revealed that CBF initially decreased and subsequently increased, especially in the second week. These changes may serve as surrogate imaging markers for RCVS-related complications, and could further contribute to understanding the pathology of RCVS. K E Y W O R D S arterial spin labeling magnetic resonance imaging, cerebral blood flow, cortical subarachnoid hemorrhage, posterior reversible encephalopathy syndrome, reversible cerebral vasoconstriction syndrome How to cite this article: Kano Y, Inui S, Uchida Y, et al. Quantitative arterial spin labeling magnetic resonance imaging analysis of reversible cerebral vasoconstriction syndrome: A

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Section: Discussionsupporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantitative arterial spin labeling magnetic resonance imaging analysis of reversible cerebral vasoconstriction syndrome: A case series

et al. 2021

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“…45 On the basis of our own clinical experience and a few isolated case reports, perfusion imaging in RCVS may show multifocal areas of hypoperfusion that often include cerebral watershed zones corresponding to the involved vascular territories (Fig 3). 46,47 These areas of perfusion abnormality may worsen acutely and, in some instances, progress to watershed infarction as previously discussed. 47 Changes in cerebral perfusion may correspond to the evolution of arterial vasoconstriction, and this information could potentially be used to track treatment response (eg, vasodilator therapy) and provide physiologic information regarding the effects of individual stenoses.…”

Section: Perfusion Imagingmentioning

confidence: 96%

“…47 Changes in cerebral perfusion may correspond to the evolution of arterial vasoconstriction, and this information could potentially be used to track treatment response (eg, vasodilator therapy) and provide physiologic information regarding the effects of individual stenoses. 46 However, given the relative paucity of published data, further research into the potential role of perfusion imaging in the evaluation and monitoring of RCVS is needed.…”

Section: Perfusion Imagingmentioning

confidence: 99%

Reversible Cerebral Vasoconstriction Syndrome, Part 2: Diagnostic Work-Up, Imaging Evaluation, and Differential Diagnosis

Miller

Shivashankar

Mossa‐Basha

et al. 2015

AJNR Am J Neuroradiol

137

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SUMMARY:The diagnostic evaluation of a patient with reversible cerebral vasoconstriction syndrome integrates clinical, laboratory, and radiologic findings. Imaging plays an important role by confirming the presence of cerebral vasoconstriction; monitoring potential complications such as ischemic stroke; and suggesting alternative diagnoses, including CNS vasculitis and aneurysmal subarachnoid hemorrhage. Noninvasive vascular imaging, including transcranial Doppler sonography and MR angiography, has played an increasingly important role in this regard, though conventional angiography remains the criterion standard for the evaluation of cerebral artery vasoconstriction. Newer imaging techniques, including high-resolution vessel wall imaging, may help in the future to better discriminate reversible cerebral vasoconstriction syndrome from primary angiitis of the CNS, an important clinical distinction. ABBREVIATIONS:PACNS ϭ primary angiitis of the CNS; RCVS ϭ reversible cerebral vasoconstriction syndrome; TCD ϭ transcranial Doppler sonography; VWI ϭ

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et al. 2019

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A case of reversible cerebral vasoconstriction syndrome presenting with recurrent neurological deficits: Evaluation using noninvasive arterial spin labeling MRI

Cited by 13 publications

References 6 publications

Quantitative arterial spin labeling magnetic resonance imaging analysis of reversible cerebral vasoconstriction syndrome: A case series

Quantitative arterial spin labeling magnetic resonance imaging analysis of reversible cerebral vasoconstriction syndrome: A case series

Reversible Cerebral Vasoconstriction Syndrome, Part 2: Diagnostic Work-Up, Imaging Evaluation, and Differential Diagnosis

Imaging of Headache

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