Anesthetic Management of Reversible Cerebral Vasoconstriction Syndrome: A Case Report

Reversible cerebral vasoconstriction syndrome: literature review

“…It can affect any age group, including children [ 10 ] and young adolescents [ 7 ]. However, it primarily affects individuals between 20 and 50 years of age [ 1 , 2 , 9 – 11 , 13 , 20 , 38 , 39 ], with a peak around 42 years of age [ 7 , 40 ]. It is more common in women than in men, with incidence rates of 2.6:1 to 10:1 [ 1 , 5 – 7 , 10 , 12 , 17 , 20 , 28 , 41 – 43 ].…”

“…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 ].…”

“…Furthermore, it demonstrated that 20% of patients had persistent neurological deficits [ 5 ]. Furthermore, cerebral edema was present in 38% of patients, death due to stroke in 2% [ 2 ], and signs of cerebral infarction and cerebral hemorrhage in approximately 10–20% of patients [ 80 ].…”

“…The Reversible Cerebral Vasoconstriction Syndrome (RCVS) is characterized by sudden headache and reversible multifocal cerebral vasoconstriction [1][2][3][4]. It is more prevalent in women [5][6][7][8], mainly because it often has puerperium as a precipitating factor [7,[9][10][11].…”

Cesarean section under general anesthesia for antepartum reversible cerebral vasoconstriction syndrome: A case report

“…Furthermore, this is the first case report describing anesthetic management of a cesarean section during antepartum RCVS. Only one case of general anesthesia management for a patient with a history of RCVS has been reported …”