Serial Assessment in Eclampsia of Cerebrohemodynamics by Combined Transcranial Doppler and Magnetic Resonance Angiography

Ikeda, Tomoaki; Urabe, Hirotoshi; Matsukage, Syoichi; Sameshima, Hiroshi; Ikenoue, Tsuyomu

doi:10.1159/000049414

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…Non-invasive MRA or CTA is preferred to conventional catheter-based angiography, and its associated complications, as RCVS tends to affect the circle of Willis or its immediate branches, which are adequately visualized with the former modalities. Alternatively, serial TCD ultrasound carried out over the course of one to two weeks may prove to demonstrate high specificity and sensitivity for RCVS and cerebral vasculitis, respectively (See Gomez et al, 1991& Ikeda et al, 2001). 70,71 Clearly, both the timing and the diagnostic performance of noninvasive vascular imaging and conventional angiography in this setting requires the performance of a prospective clinical study.…”

Section: Discussionmentioning

confidence: 99%

Syndrome de vasoconstriction cérébrale segmentale réversible ou angéite primitive du Systeme nerveux central?

Gerretsen

Kern

2007

Can. j. neurol. sci.

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Background: Reversible Cerebral Vasoconstriction Syndrome (RCVS) may present as thunderclap headache (TCH), accompanied by reversible cerebral vasospasm and focal neurological deficits, often without a clear precipitant. RCVS may be mistaken for Primary Angiitis of the Central Nervous System (PACNS) due to the presence of similar angiographic features of segmental narrowing of cerebral arteries. We discuss the clinical features of a young female migraine patient who developed TCH and was found to have RCVS following initial treatment with corticosteroids for PACNS, in the context of a systematic review of the available medical literature. Methods: A Medline TM search was performed to identify all case reports since 1966 describing RCVS and PACNS that provide sufficient clinical detail to permit diagnostic classification according to published criteria. RCVS included case studies in which there was angiographic or transcranial Doppler ultrasound evidence of near-to-complete resolution of cerebral vasoconstriction in the absence of a well-recognized secondary cause. PACNS included reports of histologically confirmed PACNS either through biopsy or necropsy. Results: Reversible Cerebral Vasoconstriction Syndrome occurs primarily in females and is characterized by sudden, severe headache at onset, normal CSF analysis, vasoconstriction involving the Circle of Willis and its immediate branches, and angiographic or TCD ultrasound evidence of near-to-complete vasospastic resolution within 1-4 weeks. It occurs typically in the context of vasoconstrictive drug use, the peripartum period, bathing, and physical exertion. Conclusion: Initial and follow-up (within 4 weeks) non-invasive angiographic studies are indicated in patients who present with TCH or who have clinical presentations that could be consistent with RCVS or PACNS in the absence of a well-recognized secondary cause, such as subarachnoid haemorrhage. Early reversibility of cerebral vasospasm is the key neuroradiological feature that supports the clinical diagnosis of RCVS. RÉSUMÉ: Syndrome de vasoconstriction cérébrale segmentaire réversible ou angéite primitive du système nerveux central? Contexte : Une céphalée en coup de tonnerre (CCT) peut être la manifestation initiale du syndrome de vasoconstriction cérébrale segmentaire réversible (SVCSR), accompagnée par un vasospasme cérébral réversible et des déficits neurologiques focaux, souvent sans facteur précipitant évident. Le SVCSR peut être confondu avec l'angéite primitive du système nerveux central (APSNC) à cause de la présence de manifestations angiographiques similaires dans ces deux pathologies, soit des rétrécissements segmentaires au niveau d'artères cérébrales. Nous discutons des manifestations cliniques observées chez une jeune femme migraineuse qui a consulté pour une CCT et chez qui on a diagnostiqué un SVCSR après un traitement initial par des corticostéroïdes pour une APSNC. Nous présentons également une revue systématique de la littérature médicale actuelle sur ce sujet. Méthodes : Nou...

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Section: Discussionmentioning

confidence: 99%

Syndrome de vasoconstriction cérébrale segmentale réversible ou angéite primitive du Systeme nerveux central?

Gerretsen

Kern

2007

Can. j. neurol. sci.

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“…In recent prospective studies of recurrent TCH and RCVS, MCA was involved in all cases [11••,12••]. Alternatively, serial transcranial Doppler/transcranial color Doppler (TCD/TCCD) ultrasound carried out over the fi rst 2 months after presentation may prove to have high specifi city and sensitivity for RCVS and cerebral vasculitis, respectively [47,48]. A prospective study of RCVS with serial TCCD found that when subjects' maximum middle cerebral artery velocity (V MCA ) met "mild vasospasm criteria for SAH" (V MCA ≥ 120 cm/sec and a Lindegaard index [V MCA /V ICA , a ratio of middle cerebral to internal carotid artery velocity] score ≥ 3) patients had a greater risk of RPLS and ischemic strokes [12••].…”

Section: Pathophysiologymentioning

confidence: 99%

Reversible cerebral vasoconstriction syndrome: A thunderclap headache-associated condition

Gerretsen

Kern

2009

Curr Neurol Neurosci Rep

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Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by a sudden, severe headache at onset, vascular narrowing involving the circle of Willis and its immediate branches, and angiographic evidence of vasoconstriction reversibility within minutes to weeks of onset. RCVS is underrecognized and often misdiagnosed; it can defy clinical detection because it can mimic common conditions such as migraine and ischemic stroke. A lack of shared nosology has hampered awareness and understanding of the syndrome. Clinicians must consider primary angiitis of the central nervous system because of its high rates of morbidity and mortality if left untreated. RCVS has a number of primary and secondary associations (cerebral hemorrhage, vasoactive substances, the peripartum period, bathing, and physical exertion) but also occurs in isolation. RCVS can present in conjunction with hypertensive encephalopathy, preeclampsia, and reversible posterior leukoencephalopathy. This review provides an up-to-date account of RCVS.

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“…These changes in cerebral blood flow can cause cerebral ischemia and hemorrhage. 8,9 For these reasons, cesarean section is often used as the delivery mode in pregnancy with Moyamoya disease. However, we also use vaginal delivery with an epidural anesthesia to decrease cerebral blood flow.…”

Section: Introductionmentioning

confidence: 99%

Vaginal delivery in pregnancy with Moyamoya disease: Experience at a single institute

Tanaka

Katsuragi

Tanaka

et al. 2014

J of Obstet and Gynaecol

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Serial Assessment in Eclampsia of Cerebrohemodynamics by Combined Transcranial Doppler and Magnetic Resonance Angiography

Cited by 6 publications

References 9 publications

Syndrome de vasoconstriction cérébrale segmentale réversible ou angéite primitive du Systeme nerveux central?

Syndrome de vasoconstriction cérébrale segmentale réversible ou angéite primitive du Systeme nerveux central?

Reversible cerebral vasoconstriction syndrome: A thunderclap headache-associated condition

Vaginal delivery in pregnancy with Moyamoya disease: Experience at a single institute

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