Reversible cerebral vasoconstriction syndrome in the postpartum period: A case report and review of the literature.

Document Type

Article

Publication Date

3-25-2023

Publication Title

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare phenomenon that can present in the postpartum period. We show the experience of a 35-year-old patient who presented with headache after an uncomplicated pregnancy and vaginal delivery. She was initially diagnosed with pre-eclampsia, and subsequently with RCVS following discovery of multifocal vascular narrowing on magnetic resonance arteriography (MRA). Verapamil was initiated, and at 1 month there was improvement intracranially, but cervical vertebral arterial narrowing, likely dissection, was discovered. Verapamil was continued and aspirin was initiated. Follow-up imaging 5 months postpartum demonstrated near-complete resolution of previously noted abnormalities, which remained stable at reimaging at 10 months postpartum. In conclusion, the symptoms of RCVS can mimic or coexist with pre-eclampsia. Early intracranial imaging such as MRA can permit timely diagnosis and facilitate appropriate management and follow-up.

Volume

Online ahead of print.

DOI

10.1002/ijgo.14756

ISSN

1879-3479

PubMed ID

36965125

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