Reversible Cerebral Vasoconstriction Syndrome with Multivessel Cervical Artery Dissections and a Double Aortic Arch

Nouh, Amre; Ruland, Sean; Schneck, Michael; Pasquale, David; Biller, José

doi:10.1016/j.jstrokecerebrovasdis.2013.08.013

Cited by 20 publications

(19 citation statements)

References 10 publications

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“…In rare cases, multiple cervical arterial dissections may be present. 47 Finally, some published series have noted a significant association between RCVS and cannabis use.…”

Section: Epidemiology and Potential Triggersmentioning

confidence: 98%

“…1,5,17 Cervical arterial dissection has also been associated with RCVS, though it remains uncertain whether this represents a potential etiology or complication of the syndrome. 7,9,[44][45][46][47] In a prospective study identifying patients with RCVS or cervical arterial dissection, Mawet et al 45 found that 12% of patients in the RCVS cohort (n ϭ 173) had or developed cervical arterial dissection, while 7% of patients in the cervical dissection cohort (n ϭ 285) developed RCVS. In rare cases, multiple cervical arterial dissections may be present.…”

Section: Epidemiology and Potential Triggersmentioning

confidence: 99%

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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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“…In rare cases, multiple cervical arterial dissections may be present. 47 Finally, some published series have noted a significant association between RCVS and cannabis use.…”

Section: Epidemiology and Potential Triggersmentioning

confidence: 98%

Section: Epidemiology and Potential Triggersmentioning

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

View full text Add to dashboard Cite

show abstract

“…Various precipitants are found in at least half the patients with RCVS (Table ), the most common being exposure to vasoactive medications or illicit drugs, including cannabis . TCH may start upon first exposure, or after long‐term use, at normal or excessive doses .…”

Section: Precipitants Of Rcvs and Associated Conditionsmentioning

confidence: 99%

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers

2016

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During the last 10 years, reversible cerebral vasoconstriction syndrome (RCVS) has emerged as the most frequent cause of thunderclap headache (TCH) in patients without aneurysmal subarachnoid hemorrhage, and as the most frequent cause of recurrent TCHs. The typical TCHs of RCVS are multiple, recurring over a few days to weeks, excruciating, short-lived, and brought up by exertion, sexual activities, emotion, Valsalva maneuvers, or bathing, among other triggers. All these triggers induce sympathetic activation. In a minority of cases with RCVS, TCH heralds stroke and rarely death. Early diagnosis of RCVS in patients who present with isolated headache enables proper management and might reduce the risk of eventual stroke. This review describes the characteristics, triggers, diagnosis, and management of TCH in RCVS. One aim is to underline that the TCH pattern of RCVS is so typical that it enables, according to the 2013 revision of the International Classification of Headache Disorders, the diagnosis of "probable RCVS" in patients with such a headache pattern, normal cerebral angiography, and no other cause. Another objective is to discuss the role of physical and emotional stress in RCVS and in other related conditions involving similar triggers.

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“…The headache associated with PACNS is often slowly progressive with an insidious onset, differing markedly from the typical thunderclap headache of RCVS in both time course and peak severity. 1,2,7,13,16,18,19,57 Patient demographics in these disease entities also demonstrate significant differences. RCVS is typically encountered in young-to-middle-aged women, as opposed to PACNS, which is most often seen in older men.…”

Section: Differential Diagnosismentioning

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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Reversible Cerebral Vasoconstriction Syndrome with Multivessel Cervical Artery Dissections and a Double Aortic Arch

Cited by 20 publications

References 10 publications

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

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

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers

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

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