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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Monday, May 10, 2021

Reversible Cerebral Vasoconstriction Syndrome

emDocs - May 09, 2021 - By Tony Spadaro and Kevin R. Scott
Reviewed by: Richard Byyny; Alex Koyfman; Brit Long
“Conclusion
  • Consider RCVS in patients with Thunderclap headache, particularly if they have had multiple episodes
  • Physical exertion, triptans, and stimulants are common provoking causes of RCVS
  • The diagnostic test of choice is CTA or MRA, which will classically show multiple segmental arterial narrowing; however, be aware that there can be a delay in imaging findings from symptom onset
  • RCVS can be associated with focal ischemia, intracerebral hemorrhage, PRES, and cervical artery dissection
  • Treatment includes calcium channel blockers such as nimodipine 30-60mg every 4 hours or a continuous infusion for severe cases. Avoid glucocorticoids, reverse anticoagulants if hemorrhage is present, and stop offending agents.”