The Neurological Institute is a leader in treating and researching the most complex neurological disorders and advancing innovations in neurology. 0000203481 00000 n
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This increasingly recognised syndrome is characterised by severe headaches, with or without other symptoms, and segmental constriction of cerebral arteries that resolves within 3 months. The major complication of RCVS is ischemic or hemorrhagic stroke. 0000103335 00000 n
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These resources provide more information about this condition or associated symptoms. 0000088882 00000 n
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The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. 0000065604 00000 n
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Reversible cerebral vasoconstriction syndrome (RCVS, sometimes called Call-Fleming syndrome) is a disease characterized by a weeks-long course of thunderclap headaches, sometimes focal neurologic signs, and occasionally seizures. Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical-radiological syndrome characterised by severe thunderclap headaches with or without other neurological symptoms and multifocal constriction of cerebral arteries that usually resolves spontaneously within 3 months. [1] Gregory Call and Marie Fleming were the first two authors of a report in which doctors from Massachusetts General Hospital, led by C. Miller Fisher, described 4 patients, alongside 12 previous case studies, with the characteristic symptoms and abnormal cerebral angiogram findings. [1] Permanent deficits are seen in a minority of patients, ranging from under 10% to 20% in various studies. [1] Symptoms can take days or a few months to manifest after a trigger. 0000097291 00000 n
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[6] Implicated drugs include selective serotonin reuptake inhibitors, weight-loss pills such as Hydroxycut, alpha-sympathomimetic decongestants, acute migraine medications, pseudoephedrine, epinephrine, cocaine, and cannabis, among many others. 0000136779 00000 n
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[6], Following a study and publication in 2007, it is also thought SSRIs, uncontrolled hypertension, endocrine abnormality, and neurosurgical trauma are indicated to potentially cause vasospasm. Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical syndrome characterized by thunderclap headache and alternating intracranial vascular vasoconstriction and vasodilation on vessel imaging; ischemic stroke, convexity subarachnoid hemorrhage (cSAH), and intraparenchymal hemorrhage can also occur. 0000042553 00000 n
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It is important to repeat the vascular imaging to ensure that the spasm that resulted in the diagnosis can be confirmed. 0000042662 00000 n
1,2 The common finding is diffuse segmental cerebral vasoconstriction of the intracranial ICAs, basilar artery, and major arteries of the circle of Willis that is spontaneously reversible in weeks to months. 0000257969 00000 n
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RCVS is usually caused when a disturbance occurs in the controlling of the muscle tone of smooth muscles that are present in the blood vessels that supply blood to the brain. [1] The pathogenesis is not known definitively, and the condition is likely to result from multiple different disease processes. 0000133446 00000 n
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8–43% of patients show neurologic problems, especially visual disturbances, but also hemiplegia, ataxia, dysarthria, aphasia, and numbness. [1] Deficits persist in a small minority of patients, with severe complications or death being very rare.