Reversible cerebral vasoconstriction syndrome in the postpartum period: A case report and review of the literature.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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.
Online ahead of print.
Lee DE, Krishnan A, Collins R. Reversible cerebral vasoconstriction syndrome in the postpartum period: a case report and review of the literature. Int J Gynaecol Obstet. 2023 Mar 25. doi: 10.1002/ijgo.14756. Epub ahead of print. PMID: 36965125.