Repetitive use of intra-arterial verapamil in the treatment of reversible cerebral vasoconstriction syndrome

French, Kris F.; Hoesch, Robert E.; Allred, Juliann; Wilder, Michael J; Smith, A. Gordon; Digre, Kathleen B.; Barge, Donald V. La

doi:10.1016/j.jocn.2011.06.016

Cited by 37 publications

(23 citation statements)

References 12 publications

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“…2 However, delay in diagnosis may preclude immunosuppressive treatment critical for CNS vasculitis disease management to prevent the debilitating long-term sequelae of stroke; or immunosuppressive treatment, wrongly administered due to incorrect diagnosis, may worsen the prognosis for RCVS. 2,17 On review of the literature, only 1 study to date has characterized the HRMRI vessel wall findings for RCVS and contrasted it with CNS vasculitis. Mandell et al, 7 compared HRMRI artery wall characteristics for RCVS and CNS vasculitis.…”

Section: Discussionmentioning

confidence: 99%

High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Obusez¹,

Hui²,

Hajj‐Ali

et al. 2014

American Journal of Neuroradiology

236

183

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BACKGROUND AND PURPOSE: High-resolution MR imaging is an emerging tool for evaluating intracranial artery disease. It has an advantage of defining vessel wall characteristics of intracranial vascular diseases. We investigated high-resolution MR imaging arterial wall characteristics of CNS vasculitis and reversible cerebral vasoconstriction syndrome to determine wall pattern changes during a follow-up period.

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Section: Discussionmentioning

confidence: 99%

High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Obusez¹,

Hui²,

Hajj‐Ali

et al. 2014

American Journal of Neuroradiology

236

183

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“…1,69,74,75 Although RCVS vasoconstriction has been shown to improve following intra-arterial vasodilator therapy, recurrence of arterial narrowing has been reported, sometimes necessitating multiple treatment sessions. 69,76 Glucocorticoid steroids have been administered to patients with RCVS, without improvement in either patient symptoms or sequelae of the disease. Some case series have even suggested that steroid therapy may be associated with worse outcomes in RCVS.…”

Section: Treatmentmentioning

confidence: 99%

“…Some case series have even suggested that steroid therapy may be associated with worse outcomes in RCVS. 3,17,76 …”

Section: Treatmentmentioning

confidence: 99%

Reversible Cerebral Vasoconstriction Syndrome, Part 1: Epidemiology, Pathogenesis, and Clinical Course

Miller

Shivashankar

Mossa‐Basha

et al. 2015

AJNR Am J Neuroradiol

208

194

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SUMMARY:Reversible cerebral vasoconstriction syndrome is a clinical and radiologic syndrome that represents a common presentation of a diverse group of disorders. The syndrome is characterized by thunderclap headache and reversible vasoconstriction of cerebral arteries, which can either be spontaneous or related to an exogenous trigger. The pathophysiology of reversible cerebral vasoconstriction syndrome is unknown, though alterations in cerebral vascular tone are thought to be a key underlying mechanism. The syndrome typically follows a benign course; however, reversible cerebral vasoconstriction syndrome may result in permanent disability or death in a small minority of patients secondary to complications such as ischemic stroke or intracranial hemorrhage.ABBREVIATIONS: RCVS ϭ reversible cerebral vasoconstriction syndrome; PRES ϭ posterior reversible encephalopathy syndrome

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“…Additionally, DSA may provide complementary information to aid the diagnosis, including reversibility of vasoconstriction following intra-arterial administration of a vasodilator. [48][49][50][51][52] Because diagnostic confirmation of RCVS is usually retrospective following spontaneous resolution of clinical and angiographic findings in 1-3 months, there is often a substantial delay in confirming the diagnosis. Consequently, demonstration of reversibility following intra-arterial vasodilator administration can be clinically useful in the early recognition of RCVS, as opposed to the partial or incomplete improvement often seen with other vasospastic disorders.…”

Section: Catheter Angiographymentioning

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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Repetitive use of intra-arterial verapamil in the treatment of reversible cerebral vasoconstriction syndrome

Cited by 37 publications

References 12 publications

High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

High-Resolution MRI Vessel Wall Imaging: Spatial and Temporal Patterns of Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Reversible Cerebral Vasoconstriction Syndrome, Part 1: Epidemiology, Pathogenesis, and Clinical Course

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

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