Seeing Double An Atypical Presentation of RCVS

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Authors

Lauren Kassab, Beaumont Health Resident
Alex Ismail, Beaumont Health Resident
Jonathan Doty, Beaumont Health Resident

Description

Reversible cerebral vasoconstriction syndrome (RCVS) is a syndrome characterized by reversible, multifocal narrowing of the cerebral arteries and a thunderclap headache (reaching a peak intensity within one minute). A less severe headache, or lack thereof, is rare (1). Additional neurologic symptoms are typically dependent on the sequelae of focal intracranial stenosis, including ischemia, PRES, and IPH. Common precipitants are cannabis, SSRIs, alcohol, cocaine, and eclampsia. Depending on the inciting cause, presentations can also widely vary over a course of months - years. Diagnosis can be pervasive, as noninvasive vascular imaging has an 80% sensitivity (2). Definitive diagnosis is made with angiogram, with vasoconstriction in at least two vessels and resolution in three months, as well as negative serology and CSF markers for vasculitis. Treatment involves identifying and reversing the offending agent, and in some cases calcium channel blockers.

Publication Date

5-4-2023

Disciplines

Neurology

Recommended Citation

Kassab L, Ismail A, Doty J. Seeing double an atypical presentation of rcvs. Presented at Beaumont Hospital Farmington Hills 2023 Alvin Yarrows Research Day; 2023 May 4; Farmington Hills, MI.

Comments

2023 Alvin Yarrows Research Day at Beaumont Hospital Farmington Hills, Farmington Hills, MI, May 4, 2023.